314P - Perioperative outcomes in advanced epithelial ovarian cancer treated with neoadjuvant bevacizumab and chemotherapy: Real-world experience from an Indian cancer centre

Background

There is insufficient evidence on the neoadjuvant use of bevacizumab before interval debulking surgery (IDS) in advanced epithelial ovarian cancer (EOC). We aimed to evaluate the perioperative outcomes in a cohort of women who underwent IDS after receiving bevacizumab added to neoadjuvant chemotherapy (Bev-NACT).

Methods

We retrospectively reviewed the medical records of all women with advanced EOC who underwent IDS between March 2021 and June 2022 after receiving Bev-NACT at Tata Medical Center. Relevant information was extracted from electronic medical records. Appropriate descriptive and survival statistics were used in the analysis.

Results

A total of 33 women underwent IDS after Bev-NACT. Stage IIIC, stage IVA, and stage IVB disease were present in 51.5%, 12.1%, and 36.4% of cases. The most common histology was high-grade serous carcinoma (95%). The median number of bevacizumab cycles received was 3 (2-5). The objective response rate with Bev-NACT was 90.9%. Complete cytoreduction at IDS was achieved in 75.8%. Chemotherapy response score was 1 in 6.1%, 2 in 72.7%, and 3 in 21.2%. Surgical complications of Clavien-Dindo grade 3 or higher occurred in 24.2% of patients. Serious adverse events attributable to bevacizumab occurred in 12.1% (fistula 3%, wound complications 3%, venous thromboembolism 3%, haemorrhage 3%), and the 30-day postoperative death rate was 3%. Median progression-free survival (PFS) was 23 months (95% CI 18-34), and the estimated 3-year PFS rate was 32%.

Conclusions

Bevacizumab added to neoadjuvant chemotherapy before IDS for advanced EOC had an acceptable safety and promising efficacy. Neoadjuvant bevacizumab in advanced EOC needs to be further evaluated in prospective studies.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.