ESMO 2012, Vienna, Austria

Treating platinum resistant ovarian cancer

Dr Andres Poveda – Fundacion Instituto Valenciano de Oncologia, Spain

This is the first time that some drug added to the standard treatment gives an advantage in progression free survival for patients in a very bad situation, patients with platinum resistant ovarian cancer. So the impact of the trial is really big in the medical community because it’s good news for our patients in the worse condition.

What setting were you giving them?

As you know, the treatment of this small… not small sub-population is palliative and the main objective of the treatment is quality of life. There are very few drugs active in this setting with short activity. So what we have shown in this trial is that the addition of bevacizumab to any of the drugs we use in that situation may double the progression free interval. So that means that the possibility to live without disease is double than before and that means that also symptom benefit is present and for patients it’s really the first light they have in this type of patients.

Have these patients been treated before for ovarian cancer?

Sometimes they are treated with drugs like topotecan, liposomal doxorubicin or weekly taxane or even without treatment because their condition is not good so if quality of life is number one then we have to be careful with it. At the moment the new standard is… so we have discovered that to add bevacizumab to any of those drugs because the possibility to have a longer progression free interval is really brilliant. So we have seen today that the population treated with weekly paclitaxel plus bevacizumab reach a PFS of more than ten months, that’s really incredible because before this the median PFS is three months. So that means that in this population a more than doubled possibility to live without disease and without progression and without symptoms.

What would be the take home message for the doctors in the clinic?

The take home message is that all the effort we made in clinical trials is really useful, if not in the present time in the immediate future. So I recommend to put patients in clinical trials because the more patients we enter the faster we obtain results in all investigations but this type of patients so giving a chance for patients with platinum resistant ovarian cancer now we have a very nice combination that gives more possibilities to live without symptoms and with a longer progression free survival.

Any difference in toxicity with these combinations?

It’s very, very similar, the toxicity, because bevacizumab is not really toxic if you are ready to manage the hypertension or proteinuria, both are the more frequent secondary effects, but there are some specific rules to manage this situation. So maybe since the treatment is longer because the patients with this combination had a longer progression free interval, then the accumulative toxicity is not related to the drug but is related to the longer administration of the treatment but no main difference in both arms.