Optimal treatment duration of bevacizumab (BEV) combined with carboplatin and paclitaxel in patients (pts) with primary epithelial ovarian (EOC), fallopian tube (FTC) or peritoneal cancer (PPC): A multicenter open-label randomized 2-arm phase 3 ENGOT/GCIG trial of the AGO Study Group, GINECO, and NSGO (AGO-OVAR 17/BOOST, GINECO OV118, ENGOT Ov-15, NCT01462890).

Authors

null

Jacobus Pfisterer

AGO Study Group & Gynecologic Oncology Center, Kiel, Germany

Jacobus Pfisterer , Florence Joly , Gunnar Kristensen , Joern Rau , Sven Mahner , Patricia Pautier , Ahmed El-Balat , Jean Emmanuel Kurtz , Ulrich Canzler , Jalid Sehouli , Martin L. Heubner , Andreas D. Hartkopf , Klaus Baumann , Annette Hasenburg , Lars Ch. Hanker , Antje Belau , Barbara Schmalfeldt , Dominik Denschlag , Tjoung-Won Park-Simon , Philipp Harter

Organizations

AGO Study Group & Gynecologic Oncology Center, Kiel, Germany, GINECO & Centre Francois Baclesse, Caen, France, NSGO & Oslo University Hospital, Oslo, Norway, AGO Study Group & Coordinating Center for Clinical Trials, Philipps-University Marburg, Marburg, Germany, AGO Study Group & University Medical Center Hamburg-Eppendorf, Hamburg, Germany & University Hospital LMU Munich, Munich, Germany, GINECO & Institut Gustave-Roussy, Villejuif, France, AGO Study Group & University Hospital Frankfurt, Frankfurt, Germany, Gineco & Institut De Cancérologie Strasbourg Europe, Strasbourg, France, AGO Study Group & University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany, AGO Study Group & Charité-Universitätsmedizin Berlin, Campus Virchow, Berlin, Germany, AGO Study Group & University Hospital Essen, Essen, Germany & Cantonal Hospital Baden AG, Baden, Switzerland, AGO Study Group & University Hospital Tübingen, Tübingen, Germany, AGO Study Group & University Hospital Gießen and Marburg, Site Marburg, Marburg, Germany & Hospital Ludwigshafen, Ludwigshafen, Germany, AGO Study Group & University Hospital Freiburg, Freiburg, Germany & University Medical Center Mainz, Mainz, Germany, AGO Study Group & University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany, AGO Study Group & University Hospital Greifswald, Greifswald, Germany & Frauenarztpraxis Dr. Belau, Greifswald, Germany, AGO Study Group & Hospital Rechts der Isar, Technical University Munich, Munich, Germany & University Medical Center Hamburg-Eppendorf, Hamburg, Germany, AGO Study Group & Hochtaunus-Kliniken, Hospital Bad Homburg, Bad Homburg, Germany, AGO Study Group & Hannover Medical School, Hannover, Germany, AGO Study Group & Kliniken Essen-Mitte, Essen, Germany

Research Funding

Pharmaceutical/Biotech Company
F. Hoffmann-La Roche Ltd., Basel, Switzerland

Background: GOG-0218 established the addition of BEV 15 mg/kg every 3 weeks (q3w) for 15 months to standard front-line chemotherapy for advanced ovarian cancer, but the optimal BEV duration remained unknown. We report primary results from a randomized phase 3 trial designed to address this question. Methods: Eligible pts with FIGO stage IIB–IV EOC, FTC, or PPC and ECOG PS ≤2 underwent primary cytoreductive surgery followed by 6 cycles of chemotherapy (paclitaxel 175 mg/m2 + carboplatin AUC 5 q3w) and BEV (15 mg/kg q3w). Pts were randomized to receive BEV for either 15 months (standard arm BEV15) or 30 months (experimental arm BEV30), stratified by FIGO stage/residual tumor (stage IIB–IIIC/no residual tumor vs stage IIB–IIIC/residual tumor or stage IV). The primary endpoint was investigator-assessed progression-free survival (PFS) according to RECIST v1.1. Secondary endpoints were overall survival (OS), objective response rate, quality of life, safety, and tolerability. The trial was designed with 80.2% power to detect a hazard ratio (HR) of 0.66 favoring BEV30 (2-sided log-rank test, 5% significance level, 10% dropout rate) after 697 PFS events. The trial was funded by F. Hoffmann-La Roche Ltd., performed according to ENGOT model A. Results: From Nov 2011 to Aug 2013, 927 women (83% with EOC) from 161 centers were randomized. Baseline characteristics were balanced between arms; median age was 61 years, 96% had ECOG PS 0/1, 58% had no residual tumor, and 77% had high-grade serous histology. Serious adverse events of special interest for BEV occurred in 51/448 pts (11%) vs 61/442 pts (14%) receiving BEV15 vs BEV30, respectively: hypertension (2.7%/4.5%), thromboembolic event (2.2%/3.2%), fistula (3.1%/1.1%), gastrointestinal perforation (0.2%/0.9%), proteinuria (0.7%/1.4%), hemorrhage (0.2%/0.9%), and myocardial infarction (0%/1.1%). Efficacy is shown in the table. Conclusions: Longer treatment with BEV for up to 30 months improves neither PFS nor OS in pts with primary EOC, FTC, or PPC. Therefore BEV treatment duration of 15 months remains standard of care. Clinical trial information: NCT01462890

EndpointBEV15 (n = 464)BEV30 (n = 463)p-value
PFS events, n (%)333 (72)340 (73)
Median PFS, months (95% CI)24.2 (22.2–26.5)26.0 (23.7–29.7)
PFS HR (95% CI)0.99 (0.85–1.15)p = 0.90
Restricted mean PFS (95% CI)*39.5 (36.3–42.7)39.3 (36.2–42.4)p = 0.92
OS events, n (%)257 (55)275 (59)
Median OS, months (95% CI)54.3 (51.0–64.6)60.0 (54.0–68.6)
OS HR (95% CI)1.04 (0.87–1.23)p = 0.68
Restricted mean OS (95% CI)*60.4 (57.2–63.6)60.8 (57.8–63.8)p = 0.87

*Performed because of evidence of nonproportional hazards, restricted at the time point of the last observed event (BEV15/BEV30).

Disclaimer

This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org

Abstract Details

Meeting

2021 ASCO Annual Meeting

Session Type

Oral Abstract Session

Session Title

Gynecologic Cancer

Track

Gynecologic Cancer

Sub Track

Ovarian Cancer

Clinical Trial Registration Number

NCT01462890

Citation

J Clin Oncol 39, 2021 (suppl 15; abstr 5501)

DOI

10.1200/JCO.2021.39.15_suppl.5501

Abstract #

5501

Abstract Disclosures