Bevacizumab treatment and quality of life in advanced ovarian cancer

Stark D, Nankivell M, Pujade-Lauraine E et al. Standard chemotherapy with or without bevacizumab in advanced ovarian cancer: quality-of-life outcomes from the International Collaboration on Ovarian Neoplasms (ICON7) Phase 3 randomised trial. Lancet Oncol. 14(3), 236-243 (2013). Despite improvements in surgery and chemotherapy treatments, the 5-year survival of ovarian cancer patients is far below 50%. As angiogenesis contributes to tumor growth and metastasis, bevacizumab, an antiangiogenetic monoclonal antibody, was studied in many solid cancers for which evidence of efficacy has been shown in several trials. The ICON7 randomized Phase III trial was designed to evaluate the addition of bevacizumab to standard chemotherapy in ovarian cancer. The ICON7 study demonstrated for patients receiving bevacizumab: a progression-free survival advantage of 2.4 months; an overall survival benefit of 8 months in patients with high risk of progression; and a less than 10-point difference in quality of life (QoL) between the two groups. A detailed assessment of ICON7 QoL confirmed that bevacizumab continuation treatment seems to be associated with a small but clinically significant decrement in QoL. As development of existing and new antiangiogenesis drugs is mainly based on continuation schedules, studies taking into account the evolving interpretation of QoL data are needed.