Work

Continuous anti-angiogenic therapy after tumor progression in patients with recurrent high-grade epithelial ovarian cancer: phase I trial experience

Year: 2016

Type: article

Abstract: // Ming-Mo Hou 1, 3, * , Zhijie Wang 4, * , Filip Janku 1 , Sarina Piha-Paul 1 , Aung Naing 1 , David Hong 1 , Shannon Westin 2 , Robert L. Coleman 2 , Anil K. Sood 2 , Apostolia M. Tsimberidou 1 , Vivek Subbiah 1 , Jennifer Wheler 1 , Ralph Zinner 1 , Karen Lu 2 , Funda Meric-Bernstam 1 , Siqing Fu 1 1 Departments of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA 2 Departments of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA 3 Division of Hematology-Oncology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan 4 Department of Thoracic Medical Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital & Beijing Institute for Cancer Research, Beijing, China * These authors have contributed equally to this work Correspondence to: Siqing Fu, e-mail: [email protected] Keywords: epithelial ovarian cancer, anti-angiogenesis, tumor progression, progression-free survival, overall survival Received: March 01, 2016 Accepted: April 10, 2016 Published: April 27, 2016 ABSTRACT High-grade epithelial ovarian cancer (HG-EOC) is the most lethal gynecologic malignancy worldwide Once patients develop chemoresistance, effective novel strategies are required to improve prognosis We analyzed characteristics and outcomes of 242 consecutive patients with HG-EOC participating in 94 phase I clinical trials at The University of Texas MD Anderson Cancer Center. Baseline lactate dehydrogenase levels, albumin levels, and number of metastatic sites were independent predictors of overall survival (OS). Receiving more than 1 phase I protocol was associated with improved OS (p < 0.001). Regimens including a chemotherapeutic agent plus bevacizumab or Aurora A kinase inhibitor led to a median progression-free survival (PFS) duration of more than 6 months. Although patients receiving bevacizumab-based regimens in the phase I clinical trials had significantly longer PFS than those receiving other anti-angiogenic therapies (p = 0.017), patients treated with vascular endothelial growth factor receptor-tyrosine kinase inhibitors (VEGFR-TKIs) had significantly longer OS (12.2 months) than those not treated with VEGFR-TKIs (8.6 months, p = 0.015). In conclusion, anti-angiogenic therapy is one of the most important strategies for the treatment of HG-EOC, even in those who have already experienced tumor progression. Therefore, eligible patients with HG-EOC should be encouraged to participate in novel phase I studies of anti-angiogenic therapies, even after disease progression.

Source: Oncotarget

DOI: 10.18632/oncotarget.9048