Article ID Journal Published Year Pages File Type
3946458 Gynecologic Oncology 2015 9 Pages PDF
Abstract

•Ixabepilone is a microtubule-stabilizing agent with activity in taxane-resistant disease•Weekly ixabepilone ± biweekly bevacizumab shows activity in uterine/ovarian cancers•This therapeutic combination warrants further prospective study

ObjectiveTo describe the clinical outcome and tolerability of weekly ixabepilone (16–20 mg/m2 days 1, 8, 15 of a 28-day cycle) ± biweekly bevacizumab (10 mg/kg days 1 and 15) in patients with recurrent/persistent uterine or ovarian/primary peritoneal/fallopian tube cancers.MethodsA single-institution retrospective review was performed inclusive of all patients who received ≥ 2 cycles from 01/2010 to 06/2014. Progression-free (PFS) and overall (OS) survival were determined using the Kaplan–Meier method. Toxicities were graded according to CTCAEv4.0. Best response was categorized using RECIST or by CA-125 criteria.ResultsA total of 60 patients (24 uterine and 36 ovarian cancers) were identified. Patients had received a median of 3.5 (range:1–10) prior lines of chemotherapy. Patients completed a mean of 4.7 ± 2.9 cycles of ixabepilone; 66.7% (16/24) and 91.7% (33/36) of patients with uterine and ovarian cancers received concurrent bevacizumab. For uterine cancers, objective response rate (ORR) was 41.7% (12.5% complete, 29.2% partial); median duration of response or stabilization was 7 months (range:2–30). Median PFS and OS were 5.2 and 9.6 months, respectively. PFS and OS were improved in the setting of concurrent bevacizumab (6.5 versus 3.0 months, p = 0.01, HR 0.2, 95% CI 0.05–0.77; 9.6 versus 4.2 months, p = 0.02, HR 0.58, 95% CI 0.04–0.74). Similar ORR was observed among ovarian cancers; median PFS/OS were not yet reached. Most toxicities were grade 1/2.ConclusionsWeekly ixabepilone with or without biweekly bevacizumab has promising activity and acceptable toxicity in patients with platinum-/taxane-resistant endometrial and ovarian cancers. This combination warrants further prospective study in these populations.

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Health Sciences Medicine and Dentistry Obstetrics, Gynecology and Women's Health
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