Outcome according to residual disease (surgeon's report vs pre‐chemotherapy imaging) in patients with bevacizumab‐treated ovarian cancer: Analysis of the ROSiA study. Issue 4 (31st July 2019)

• Record Type: Journal Article
• Authors: Korach, Jacob; Colombo, Nicoletta; Mendiola, Cesar; Selle, Frédéric; Dolado, Ignacio; Donica, Margarita; Oza, Amit M.
• Is Part Of: Journal of surgical oncology. Volume 120:Issue 4(2019)
• Page Start: 786
• Page End: 793
• Publication Date: 2019-07-31
• Subjects: bevacizumab -- imaging -- ovarian cancer -- progression‐free survival -- visible residuum; Cancer -- Surgery -- Periodicals; Neoplasms -- Periodicals; 616
• DOI: 10.1002/jso.25647
• Languages: English
• ISSNs: 0022-4790

Abstract

Abstract: Background and Objectives: The single‐arm ROSiA study evaluated frontline bevacizumab for advanced ovarian cancer. We explored how discordant surgically and radiologically assessed postoperative residual disease affects outcomes. Methods: After debulking surgery, 1021 patients received 4 to 8 cycles of carboplatin‐paclitaxel plus bevacizumab until progression or up to 24 months. The primary endpoint was safety; progression‐free survival (PFS) was a secondary endpoint. We performed post hoc exploratory PFS analyses in four subgroups: surgeon‐reported no visible residuum (NVR) without target lesions; surgeon‐reported NVR with target lesions; macroscopic (≤1 cm) residuum; and >1 cm residuum. Results: Surgical and radiological assessments were concordant in 94% of patients; 61 patients (6%; 21% of those with surgeon‐reported NVR) had NVR with target lesions. Median PFS was numerically longest in patients with concordant surgically/radiologically assessed NVR (35.5 months), intermediate for surgeon‐reported NVR with target lesions (31.8 months), and shortest for visible residuum (27.9 and 20.2 months for visible residuum ≤1 and >1 cm, respectively). One‐year and 2‐year PFS rates showed the same pattern. Conclusions: These analyses suggest that prognosis is potentially worse in patients with radiologically detected target lesions despite surgeon‐reported NVR compared with concordant NVR by both assessment methods. Postsurgical imaging may add valuable prognostic information.