986P - Bevacizumab plus metronomic cyclophosphamide for heavily pretreated ovarian cancer: a single institution experience

Date 29 September 2012
Event ESMO Congress 2012
Session Poster presentation I
Topics Anticancer Agents
Ovarian Cancer
Biological Therapy
Presenter Ismael Ghanem
Authors I. Ghanem1, C. Mendiola1, A. Diaz1, G. Velasco1, L. Manso2, E. Ciruelos2, R.A. Manneh1, S. Hoyos1, T. Pascual1, H. Cortes-Funes3
  • 1Medical Oncology, Hopital 12 de Octubre, 28005 - Madrid/ES
  • 2Medical Oncology, Hopital 12 de Octubre, Madrid/ES
  • 3Servicio De Oncologia Medica, Hopital 12 de Octubre, 28005 - Madrid/ES



Bevacizumab in combination with chemotherapy has demonstrated activity for ovarian cancer in first and second lines. The purpose of this study is to evaluate the efficacy and safety of bevacizumab plus metronomic cyclophosphamide in heavily pretreated ovarian cancer patients


We reviewed retrospectively 29 patients (p) with recurrent ovarian cancer treated with bevacizumab 10 mg/Kg IV every 14 days plus oral cyclophosphamide 50 mg daily between January 2007 and January 2012 at a single institution. P characteristics, tumour features, survival data and adverse events (AE) were collected.


Twenty-nine p with a median age of 59 years old (31-79) and ECOG 1 (0-2) were analyzed. Fifteen (52%) and 14 (48%) p had stage IV and IIIC respectively before receiving bevacizumab-cyclophosphamide. The most frequent pathologic subtype was serous in 22 p (76%). The median of previous lines was 4 (2-9), including drugs as carboplatin 29p (100%), paclitaxel 29p (100%), pegylated liposomal doxorubicin 26p (90%), gemcitabine 20p (69%), altretamine 10p (34%), topotecan 9p (31%) or trabectedine 1p (3%). Twenty-three cases (79%) were platinum-resistant (progression free interval less than 6 months from last platinum treatment). The median of cycles administered was 9 (3-67). Twenty-six p were assessable for CA 125 marker evaluation: 4p (15%) had CA125 normalization, 7p (27%) partial response (PR), 8p (31%) stable disease (SD) and 7p (27%) progression disease (PD). The radiologic evaluation was performed in 23 patients: There were 6p (26%) with PR, 9p (39%) with SD and 8p (35%) with PD. Median progression free survival (PFS) and overall survival (OS) were 3.7 months and 12.1 months respectively. P with platinum-resistant disease had significantly worse PFS (3.2m vs 36.0m) p = 0.001 and OS (12m vs not reached) p = 0.009. P with ECOG >1 also had worse PFS (2.8m vs 4.7m) p = 0.047 and OS (5.4m vs 34.5m) p = 0.011). Severe AE were G3 arterial hypertension (1p), G3 mucositis (1p), G3 anaemia and G4 digestive bleeding (1p). No alopecia and neurotoxicity deterioration were observed.


This schedule consisting on bevacizumab plus metronomic cyclophosphamide shows activity in heavily pre-treated ovarian cancer with a well toxicity profile


All authors have declared no conflicts of interest.