NEO-ADJUVANT VERSUS ADJUVANT USE OF BEVACIZUMAB IN THE MANAGEMENT OF ADVANCED OVARIAN CANCER | ||||
| Bulletin of Pharmaceutical Sciences Assiut University | ||||
| Article 18, Volume 47, Issue 1, June 2024, Page 273-287 PDF (988.49 K) | ||||
| Document Type: Review Article | ||||
| DOI: 10.21608/bfsa.2023.245511.1957 | ||||
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| Authors | ||||
Nada Hassan Salah  1; hisham ahmed aboutaleb2; mohammed alaa el din hassan3; Mohammed abdelHakim Mekkawy4; ola nabih abdel fattah5
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| 1Clinical oncology department -faculty of medicine-Assiut university | ||||
| 2women health hospital -faculty of medicine assiut university | ||||
| 3clinical oncology departement - faculty of medicine- assiut university | ||||
| 4clinical oncology department -faculty of medicine- assiut university | ||||
| 5clinical oncology department , faculty of medicine Assiut university | ||||
| Abstract | ||||
| Ovarian cancer (OC) is the most lethal gynecologic malignancy . In 2018, Bevacizumab was approved by FDA for use with chemotherapy as treatment for women with advanced OC. Objective: assessing the response, survival, and toxicity of Bevacizumab in patients who used it as Neoadjuvant or adjuvant with systemic therapy compared with cases who received only post-operative chemotherapy. Design: an interventional prospective case-control study. included patients with AOCs presented to Assiut University hospitals from 2018 until 2021. Intervention(s): group A: 15 patients underwent primary surgical resection then received adjuvant treatment , group B: 17 patients received NACT then underwent surgical resection followed by adjuvant therapy. and control group(C): 19 patients received only post-operative chemotherapy without Bevacizumab and were reviewed retrospectively. Primary outcome: disease free survival (DFS), and overall survival (OS). Secondary outcome: toxicity of Bevacizumab Results: Comparisons between groups A and B revealed no significant differences regarding DFS, OS and toxicity. At one-year post-treatment there was a significantly lower CA-125 values in patients who used Bevacizumab (A&B) than conventional chemotherapy (group C). The 3 years OS was 25% for Groups (A&B) and only 5% for Group C. Conclusions: bevacizumab improved response rate and overall survival without significant increase in side effects. Using it as adjuvant and as neo-adjuvant produced comparable success rates: taking in consideration that the neo-adjuvant use was applied to more advanced or irresectable cases: this means that bevacizumab could give this group an outcome similar to the primarily operable cases; larger studies are needed to confirm our findings. | ||||
| Keywords | ||||
| ovarian cancer; Bevacizumab; advanced; neoadjuvant | ||||
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