Bevacizumab for newly diagnosed ovarian cancers: best candidates among high-risk disease patients (ICON-7)
Menée à partir de données portant sur 1 386 patientes atteintes d'un cancer de l'ovaire de stade avancé et incluses dans un essai de phase III, cette étude évalue la performance du modèle KELIM, basé sur la cinétique longitudinale de l'antigène CA125 lors des 100 premiers jours de la chimiothérapie, pour identifier, parmi les patientes présentant un haut risque de récidive, celles pouvant bénéficier du bévacizumab
Bevacizumab is approved as a maintenance treatment in first-line seeting in advanced stage III-IV ovarian cancers, because GOG-0218 and ICON-7 phase III trials demonstrated progression-free survival (PFS) benefits. However, only the subgroup of patients with high-risk diseases (stage IV, and incompletely resected stage III) derived an overall survival (OS) gain in ICON- 7 trial (4.8 months). The modeled CA-125 KELIM parameter, based on the longitudinal CA-125 kinetics during the first 100 days of chemotherapy, is a potential indicator of the tumor primary chemosensitivity. In ICON-7 trial dataset, the OS of patients within the low- and high-risk disease groups were assessed according to treatment arms, and KELIM. Among the patients with high-risk diseases, those with favorable standardized KELIM ≥ 1.0 (n = 214, 46.7%) had no survival benefit from bevacizumab, while those with unfavorable KELIM < 1.0 ( n = 244, 53.2%) derived the highest OS benefit (absolute difference = 9.1 months, two-sided Log-rank P = 0.10; Cox HR = 0.78, 95% CI = 0.58-1.04, two-sided P = 0.09).
JNCI Cancer Spectrum , article en libre accès, 2019