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Real-world study of adding bevacizumab to chemotherapy for ovarian, tubal, and peritoneal cancer as front-line or relapse therapy (ROBOT): an observational cohort study
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  • Pei-Ying Wu,
  • Ya-Min Cheng,
  • Meng-Ru Shen,
  • Yi-Chun Chen,
  • YU-FANG HUANG,
  • Cheng-Yang Chou
Pei-Ying Wu
National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University
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Ya-Min Cheng
National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University
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Meng-Ru Shen
National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University
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Yi-Chun Chen
National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University
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YU-FANG HUANG
National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University
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Cheng-Yang Chou
National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University
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Abstract

Objective. This study aimed to determine the real-world, long-term prognostic impact and adverse effects (AEs) of bevacizumab (BEV) in Asian patients with ovarian/tubal/peritoneal cancers. Design Hospital-based observational cohort study. Setting Tertiary medical centre in Southern Taiwan. Population Women diagnosed with ovarian, tubal, peritoneal cancer. Methods. We retrospectively reviewed the medical records of consecutive patients on front-line chemotherapy with or without BEV (Cohort 1) and those who relapsed following chemotherapy and/or BEV (Cohort 2) between 2011 and 2018. Main outcome measures Patient clinicopathological characteristics, BEV dosages, clinical outcomes, survivals, and AEs were analysed. Hazard ratios for disease progression and death were analysed using a Cox model. Results. Benefits of BEV used throughout triweekly, in terms of improved progression-free survival (PFS) and overall survival (OS), were observed at a dosage of 7.5–15 mg/kg/cycle among advanced-stage Cohort 1 patients. A progression-free interval of <6 months was the strongest predictor of disease progression and death in advanced-stage patients. BEV throughout and optimal cytoreduction were independent predictors of reduced disease progression. Histology was not a prognostic predictor. BEV resulted in improved OS in Cohort 2 patients, especially in the platinum-sensitive subgroup. Most patients had a front-line BEV dosage <10 mg/kg per cycle with <10 treatment cycles. Low rates and grades of BEV-related AEs were observed. Conclusions BEV used throughout effectively extended PFS and OS in advanced-stage patients. Patients with platinum-sensitive carcinoma, treated with BEV, had a significant improvement in OS and extended PFS. Therefore, BEV can safely be added to chemotherapy for ovarian/tubal/peritoneal cancers.