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Bevacizumab use in the frontline, maintenance and recurrent settings for ovarian cancer

    Carolyn E Haunschild

    Clinical Instructor, Department of Obstetrics & Gynecology, Research Fellow, Division of Gynecologic Oncology, University of California, 333 City Blvd West, Suite 1400, Orange, CA 92868, USA

    &
    Krishnansu S Tewari

    *Author for correspondence: Tel.: +1 714 456 8020; Fax: +1 714 456 6632;

    E-mail Address: ktewari@uci.edu

    Professor & Division Director, Director, Division of Gynecologic Oncology, University of California, 333 City Blvd, Orange, CA 92868, USA

    Department of Obstetrics & Gynecology, University of California, The City Tower, 333 City Blvd, West – Suite 1400, Orange, CA 92868, USA

    Published Online:https://doi.org/10.2217/fon-2019-0042

    On 13 June 2018, Genentech, Inc. issued a press release announcing that the US FDA had approved the antiangiogenesis drug, bevacizumab, in combination with chemotherapy for frontline and maintenance therapy for women with newly diagnosed ovarian cancer. Regulatory approval was based on the National Cancer Institute-sponsored Gynecologic Oncology Group (GOG) protocol 0218, the Phase III, randomized, placebo-controlled, double-blind, multi-center and multi-national clinical trial that met its primary end point, progression-free survival. Bevacizumab is now approved in the frontline, platinum-sensitive recurrent and platinum-resistant recurrent settings for epithelial ovarian cancer. This review will address the broad range of clinical trials addressing the efficacy of bevacizumab use in ovarian cancer.

    Papers of special note have been highlighted as: • of interest; •• of considerable interest

    References

    • 1. Chen H, Ye D, Xie X, Chen B, Lu W. VEGF, VEGFRs expressions and activated STATs in ovarian epithelial carcinoma. Gynecol. Oncol. 94(3), 630–635 (2004).
    • 2. Ozols RF, Bundy BN, Greer BE et al. Phase III trial of carboplatin and paclitaxel compared with cisplatin and paclitaxel in patients with optimally resected stage III ovarian cancer: a Gynecologic Oncology Group study. J. Clin. Oncol. 21(17), 3194–3200 (2003).
    • 3. Wild R, Dings RP, Subramanian I, Ramakrishnan S. Carboplatin selectively induces the VEGF stress response in endothelial cells: potentiation of antitumor activity by combination treatment with antibody to VEGF. Int. J. Cancer 110(3), 343–351 (2004).
    • 4. Chan JK, Brady MF, Penson RT et al. Weekly vs. every-3-week paclitaxel and carboplatin for ovarian cancer. N. Engl. J. Med. 374(8), 738–748 (2016).
    • 5. Burger RA, Sill MW, Monk BJ, Greer BE, Sorosky JI. Phase II trial of bevacizumab in persistent or recurrent epithelial ovarian cancer or primary peritoneal cancer: a gynecologic oncology group study. J. Clin. Oncol. 25(33), 5165–5171 (2007).
    • 6. Cannistra SA, Matulonis UA, Penson RT et al. Phase II study of bevacizumab in patients with platinum-resistant ovarian cancer or peritoneal serous cancer. J. Clin. Oncol. 25(33), 5180–5186 (2007).
    • 7. Garcia AA, Hirte H, Fleming G et al. Phase II clinical trial of bevacizumab and low-dose metronomic oral cyclophosphamide in recurrent ovarian cancer: a trial of the California, Chicago, and Princess Margaret Hospital Phase II Consortia. J. Clin. Oncol. 26(1), 76–82 (2008).
    • 8. Burger RA, Brady MF, Bookman MA et al. Incorporation of bevacizumab in the primary treatment of ovarian cancer. N. Engl. J. Med. 365(26), 2473–2483 (2011). •• Published Phase III clinical trials reviewed in this paper.
    • 9. Perren TJ, Swart AM, Pfisterer J et al. A Phase 3 trial of bevacizumab in ovarian cancer. N. Engl. J. Med. 365(26), 2484–2496 (2011). •• Published Phase III clinical trials reviewed in this paper.
    • 10. Pujade-Lauraine E, Hilpert F, Weber B et al. Bevacizumab combined with chemotherapy for platinum-resistant recurrent ovarian cancer: the AURELIA open-label randomized Phase III trial. J. Clin. Oncol. 32(13), 1302–1308 (2014). •• Published Phase III clinical trials reviewed in this paper.
    • 11. Aghajanian C, Blank SV, Goff BA et al. OCEANS: a randomized, double-blind, placebo-controlled Phase III trial of chemotherapy with or without bevacizumab in patients with platinum-sensitive recurrent epithelial ovarian, primary peritoneal, or fallopian tube cancer. J. Clin. Oncol. 30(17), 2039–2045 (2012). •• Published Phase III clinical trials reviewed in this paper.
    • 12. Coleman RL, Brady MF, Herzog TJ et al. Bevacizumab and paclitaxel–carboplatin chemotherapy and secondary cytoreduction in recurrent, platinum-sensitive ovarian cancer (NRG Oncology/Gynecologic Oncology Group study GOG-0213): a multicentre, open-label, randomised, Phase 3 trial. Lancet Oncol. 18(6), 779–791 (2017). •• Published Phase III clinical trials reviewed in this paper.
    • 13. Burger RA, Brady MF, Rhee J et al. Independent radiologic review of the Gynecologic Oncology Group Study 0218, a Phase III trial of bevacizumab in the primary treatment of advanced epithelial ovarian, primary peritoneal, or fallopian tube cancer. Gynecol. Oncol. 131(1), 21–26 (2013).
    • 14. Burger RA, Enserro D, Tewari KS et al. Final overall survival (OS) analysis of an international randomized trial evaluating bevacizumab (BEV) in the primary treatment of advanced ovarian cancer: a NRG oncology/Gynecologic Oncology Group (GOG) study. J. Clin. Oncol. 36(15 Suppl.), 5517–5517 (2018).
    • 15. Oza AM, Cook AD, Pfisterer J et al. Standard chemotherapy with or without bevacizumab for women with newly diagnosed ovarian cancer (ICON7): overall survival results of a Phase 3 randomised trial. Lancet Oncol. 16(8), 928–936 (2015).
    • 16. Ruan G, Ye L, Liu G, An J, Sehouli J, Sun P. The role of bevacizumab in targeted vascular endothelial growth factor therapy for epithelial ovarian cancer: an updated systematic review and meta-analysis. Onco Targets Ther. 11, 521–528 (2018).
    • 17. Zhou M, Yu P, Qu X, Liu Y, Zhang J. Phase III trials of standard chemotherapy with or without bevacizumab for ovarian cancer: a meta-analysis. PLoS ONE 8(12), e81858 (2013). • This meta-analysis forms the basis of Table 2.
    • 18. Oza AM, Selle F, Davidenko I et al. Efficacy and safety of bevacizumab-containing therapy in newly diagnosed ovarian cancer: ROSiA single-arm Phase 3B study. Int. J. Gynecol. Cancer 27(1), 50–58 (2017).
    • 19. Aghajanian C, Goff B, Nycum LR, Wang YV, Husain A, Blank SV. Final overall survival and safety analysis of OCEANS, a Phase 3 trial of chemotherapy with or without bevacizumab in patients with platinum-sensitive recurrent ovarian cancer. Gynecol. Oncol. 139(1), 10–16 (2015).
    • 20. Richardson DL, Backes FJ, Hurt JD et al. Which factors predict bowel complications in patients with recurrent epithelial ovarian cancer being treated with bevacizumab? Gynecol. Oncol. 118(1), 47–51 (2010).
    • 21. Burger RA, Brady MF, Bookman MA et al. Risk factors for GI adverse events in a Phase III randomized trial of bevacizumab in first-line therapy of advanced ovarian cancer: a gynecologic oncology group study. J. Clin. Oncol. 32(12), 1210–1217 (2014).
    • 22. Diaz JP, Tew WP, Zivanovic O et al. Incidence and management of bevacizumab-associated gastrointestinal perforations in patients with recurrent ovarian carcinoma. Gynecol. Oncol. 116(3), 335–339 (2010).
    • 23. Vergote I, Tropé CG, Amant F et al. Neoadjuvant chemotherapy or primary surgery in stage IIIC or IV ovarian cancer. N. Engl. J. Med. 363(10), 943–953 (2010).
    • 24. Rouzier R, Gouy S, Selle F et al. Efficacy and safety of bevacizumab-containing neoadjuvant therapy followed by interval debulking surgery in advanced ovarian cancer: results from the ANTHALYA trial. Eur. J. Cancer 70, 133–142 (2017).
    • 25. Tanyi JL, McCann G, Hagemann AR et al. Clinical predictors of bevacizumab-associated gastrointestinal perforation. Gynecol. Oncol. 120(3), 464–469 (2011).
    • 26. Martin JY, Urban RR, Liao JB, Goff BA. Bevacizumab toxicity in heavily pretreated recurrent epithelial ovarian, fallopian tube, and primary peritoneal cancers. J. Gynecol. Oncol. 27(5), e47 (2016).
    • 27. Monk BJ, Huang HQ, Burger RA et al. Patient reported outcomes of a randomized, placebo-controlled trial of bevacizumab in the front-line treatment of ovarian cancer: a Gynecologic Oncology Group Study. Gynecol. Oncol. 128(3), 573–578 (2013).
    • 28. Petrillo M, Paris I, Vizzielli G et al. Neoadjuvant chemotherapy followed by maintenance therapy with or without bevacizumab in unresectable high-grade serous ovarian cancer: a case-control study. Ann. Surg. Oncol. 22(3), 952–958 (2015).
    • 29. Daniele G, Lorusso D, Scambia G et al. Feasibility and outcome of interval debulking surgery (IDS) after carboplatin-paclitaxel-bevacizumab (CPB): a subgroup analysis of the MITO-16A-MaNGO OV2A Phase 4 trial. Gynecol. Oncol. 144(2), 256–259 (2017).
    • 30. Katsumata N, Yasuda M, Takahashi F et al. Dose-dense paclitaxel once a week in combination with carboplatin every 3 weeks for advanced ovarian cancer: a Phase 3, open-label, randomised controlled trial. Lancet 374(9698), 1331–1338 (2009).
    • 31. Pignata S, Scambia G, Katsaros D et al. Carboplatin plus paclitaxel once a week versus every 3 weeks in patients with advanced ovarian cancer (MITO-7): a randomised, multicentre, open-label, Phase 3 trial. Lancet Oncol. 15(4), 396–405 (2014).
    • 32. Clamp AR, McNeish I, Dean A et al. 929O_PRICON8: a GCIG Phase III randomised trial evaluating weekly dose- dense chemotherapy integration in first-line epithelial ovarian/fallopian tube/primary peritoneal carcinoma (EOC) treatment: results of primary progression- free survival (PFS) analysis. Ann. Oncol. 28(Suppl. 5), mdx440.039–mdx440.039 (2017).
    • 33. Gonzalez-Martin A, Gladieff L, Tholander B et al. Efficacy and safety results from OCTAVIA, a single-arm Phase II study evaluating front-line bevacizumab, carboplatin and weekly paclitaxel for ovarian cancer. Eur. J. Cancer 49(18), 3831–3838 (2013).
    • 34. Gonzalez-Martin A, Gladieff L, Tholander B et al. Updated results from OCTAVIA (front-line bevacizumab, carboplatin and weekly paclitaxel therapy for ovarian cancer). Eur. J. Cancer 50(4), 862–863 (2014).
    • 35. Armstrong DK, Bundy B, Wenzel L et al. Intraperitoneal cisplatin and paclitaxel in ovarian cancer. N. Engl. J. Med. 354(1), 34–43 (2006).
    • 36. Konner JA, Grabon DM, Gerst SR et al. Phase II study of intraperitoneal paclitaxel plus cisplatin and intravenous paclitaxel plus bevacizumab as adjuvant treatment of optimal stage II/III epithelial ovarian cancer. J. Clin. Oncol. 29(35), 4662–4668 (2011).
    • 37. Walker JL, Wenzel L, Huang H, Brady MF. Patient-reported outcomes in GOG 252: NRG oncology study of IV vs IP chemotherapy for ovarian, fallopian, or peritoneal carcinoma. Gynecol. Oncol. 141, 208 (2016).
    • 38. van Driel WJ, Koole SN, Sikorska K et al. Hyperthermic intraperitoneal chemotherapy in ovarian cancer. N. Engl. J. Med. 378(3), 230–240 (2018).
    • 39. Gouy S, Ferron G, Glehen O et al. Results of a multicenter Phase I dose-finding trial of hyperthermic intraperitoneal cisplatin after neoadjuvant chemotherapy and complete cytoreductive surgery and followed by maintenance bevacizumab in initially unresectable ovarian cancer. Gynecol. Oncol. 142(2), 237–242 (2016).
    • 40. Herzog TJ, Monk BJ, Rose PG et al. A Phase II trial of oxaliplatin, docetaxel, and bevacizumab as first-line therapy of advanced cancer of the ovary, peritoneum, and fallopian tube. Gynecol. Oncol. 132(3), 517–525 (2014).
    • 41. Andreas DB, Alexander R, Eric PL, Philipp H, Isabelle RC, Jacobus P. Role of surgical outcome as prognostic factor in advanced epithelial ovarian cancer: a combined exploratory analysis of 3 prospectively randomized Phase 3 multicenter trials. Cancer 115(6), 1234–1244 (2009).
    • 42. Parmar MK, Ledermann JA, Colombo N et al. Paclitaxel plus platinum-based chemotherapy versus conventional platinum-based chemotherapy in women with relapsed ovarian cancer: the ICON4/AGO-OVAR-2.2 trial. Lancet 361(9375), 2099–2106 (2003).
    • 43. Pfisterer J, Plante M, Vergote I et al. Gemcitabine plus carboplatin compared with carboplatin in patients with platinum-sensitive recurrent ovarian cancer: an intergroup trial of the AGO-OVAR, the NCIC CTG, and the EORTC GCG. J. Clin. Oncol. 24(29), 4699–4707 (2006).
    • 44. Pujade-Lauraine E, Wagner U, Aavall-Lundqvist E et al. Pegylated liposomal doxorubicin and carboplatin compared with paclitaxel and carboplatin for patients with platinum-sensitive ovarian cancer in late relapse. J. Clin. Oncol. 28(20), 3323–3329 (2010).
    • 45. Aghajanian C, Goff B, Nycum LR, Wang Y, Husain A, Blank S. Independent radiologic review: bevacizumab in combination with gemcitabine and carboplatin in recurrent ovarian cancer. Gynecol. Oncol. 133(1), 105–110 (2014).
    • 46. Pfisterer J, Shannon C, Hein A et al. 933OCarboplatin/pegylated liposomal doxorubicin/bevacizumab (CD-BEV) vs. carboplatin/gemcitabine/bevacizumab (CG-BEV) in patients with recurrent ovarian cancer: a prospective randomized Phase III ENGOT/GCIG-Intergroup study (AGO study group, AGO-Austria, ANZGOG, GINECO, ANZGOG, GINECO, GINECO, SGCTG). Ann. Oncol. 29(Suppl. 8), viii332–viii358 (2018).
    • 47. Hanker LC, on behalf of the AGOaGsg, Loibl S et al. The impact of second to sixth line therapy on survival of relapsed ovarian cancer after primary taxane/platinum-based therapy. Ann. Oncol. 23(10), 2605–2612 (2012).
    • 48. Husain A, Wang Y, Hanker LC et al. Independent radiologic review of AURELIA, a Phase 3 trial of bevacizumab plus chemotherapy for platinum-resistant recurrent ovarian cancer. Gynecol. Oncol. 142(3), 465–470 (2016).
    • 49. Bamias A, Gibbs E, Khoon Lee C et al. Bevacizumab with or after chemotherapy for platinum-resistant recurrent ovarian cancer: exploratory analyses of the AURELIA trial. Ann. Oncol. 28(8), 1842–1848 (2017).
    • 50. Trillsch F, Mahner S, Hilpert F et al. Prognostic and predictive effects of primary versus secondary platinum resistance for bevacizumab treatment for platinum-resistant ovarian cancer in the AURELIA trial. Ann. Oncol. 27(9), 1733–1739 (2016).
    • 51. Stockler MR, Hilpert F, Friedlander M et al. Patient-reported outcome results from the open-label Phase III AURELIA trial evaluating bevacizumab-containing therapy for platinum-resistant ovarian cancer. J. Clin. Oncol. 32(13), 1309–1316 (2014).
    • 52. Poveda AM, Selle F, Hilpert F et al. Bevacizumab combined with weekly paclitaxel, pegylated liposomal doxorubicin, or topotecan in platinum-resistant recurrent ovarian cancer: analysis by chemotherapy cohort of the randomized Phase III AURELIA Trial. J. Clin. Oncol. 33(32), 3836–3838 (2015).
    • 53. Tillmanns TD, Lowe MP, Walker MS, Stepanski EJ, Schwartzberg LS. Phase II clinical trial of bevacizumab with albumin-bound paclitaxel in patients with recurrent, platinum-resistant primary epithelial ovarian or primary peritoneal carcinoma. Gynecol. Oncol. 128(2), 221–228 (2013).
    • 54. Verschraegen CF, Czok S, Muller CY et al. Phase II study of bevacizumab with liposomal doxorubicin for patients with platinum- and taxane-resistant ovarian cancer. Ann. Oncol. 23(12), 3104–3110 (2012).
    • 55. Kudoh K, Takano M, Kouta H et al. Effects of bevacizumab and pegylated liposomal doxorubicin for the patients with recurrent or refractory ovarian cancers. Gynecol. Oncol. 122(2), 233–237 (2011).
    • 56. Hagemann AR, Novetsky AP, Zighelboim I et al. Phase II study of bevacizumab and pemetrexed for recurrent or persistent epithelial ovarian, fallopian tube or primary peritoneal cancer. Gynecol. Oncol. 131(3), 535–540 (2013).
    • 57. Musa F, Pothuri B, Blank SV et al. Phase II study of irinotecan in combination with bevacizumab in recurrent ovarian cancer. Gynecol. Oncol. 144(2), 279–284 (2017).
    • 58. Monk BJ, Han E, Josephs-Cowan CA, Pugmire G, Burger RA. Salvage bevacizumab (rhuMAB VEGF)-based therapy after multiple prior cytotoxic regimens in advanced refractory epithelial ovarian cancer. Gynecol. Oncol. 102(2), 140–144 (2006).
    • 59. Fuh KC, Secord AA, Bevis KS et al. Comparison of bevacizumab alone or with chemotherapy in recurrent ovarian cancer patients. Gynecol. Oncol. 139(3), 413–418 (2015).
    • 60. Pietzner K, Richter R, Chekerov R et al. Bevacizumab in heavily pre-treated and platinum resistant ovarian cancer: a retrospective study of the North-Eastern German Society of Gynaecologic Oncology (NOGGO) Ovarian Cancer Study Group. Anticancer Res. 31(8), 2679–2682 (2011).
    • 61. O’Malley DM, Richardson DL, Rheaume PS et al. Addition of bevacizumab to weekly paclitaxel significantly improves progression-free survival in heavily pretreated recurrent epithelial ovarian cancer. Gynecol. Oncol. 121(2), 269–272 (2011).
    • 62. Chura JC, Van Iseghem K, Downs LS, Carson LF, Judson PL. Bevacizumab plus cyclophosphamide in heavily pretreated patients with recurrent ovarian cancer. Gynecol. Oncol. 107(2), 326–330 (2007).
    • 63. Monk BJ, Pujade-Lauraine E, Burger RA. Integrating bevacizumab into the management of epithelial ovarian cancer: the controversy of front-line versus recurrent disease. Ann. Oncol. 24(Suppl. 10), x53–x58 (2013).
    • 64. Rauh-Hain JA, Guseh SH, Esselen KM et al. Patterns of recurrence in patients treated with bevacizumab in the primary treatment of advanced epithelial ovarian cancer. Int. J. Gynecol. Cancer 23(7), 1219–1225 (2013).
    • 65. von Minckwitz G, Puglisi F, Cortes J et al. Bevacizumab plus chemotherapy versus chemotherapy alone as second-line treatment for patients with HER2-negative locally recurrent or metastatic breast cancer after first-line treatment with bevacizumab plus chemotherapy (TANIA): an open-label, randomised Phase 3 trial. Lancet Oncol. 15(11), 1269–1278 (2014).
    • 66. Bennouna J, Sastre J, Arnold D et al. Continuation of bevacizumab after first progression in metastatic colorectal cancer (ML18147): a randomised Phase 3 trial. Lancet Oncol. 14(1), 29–37 (2013).
    • 67. Pignata S, Lorusso D, Joly F et al. Chemotherapy plus or minus bevacizumab for platinum-sensitive ovarian cancer patients recurring after a bevacizumab containing first line treatment: the randomized Phase 3 trial MITO16B-MaNGO OV2B-ENGOT OV17. J. Clin. Oncol. 36(15 Suppl.), 5506–5506 (2018).
    • 68. Laskey RA, Richard SD, Smith AL et al. Retreatment with bevacizumab in patients with gynecologic malignancy is associated with clinical response and does not increase morbidity. Onco Targets Ther. 7, 469–476 (2014).
    • 69. Backes FJ, Richardson DL, McCann GA et al. Should bevacizumab be continued after progression on bevacizumab in recurrent ovarian cancer? Int. J. Gynecol. Cancer 23(5), 833–838 (2013).
    • 70. Eskander RN, Tewari KS. Emerging treatment options for management of malignant ascites in patients with ovarian cancer. Int. J. Womens Health 4, 395–404 (2012).
    • 71. Zhao H, Li X, Chen D et al. Intraperitoneal administration of cisplatin plus bevacizumab for the management of malignant ascites in ovarian epithelial cancer: results of a Phase III clinical trial. Med. Oncol. 32(2), 292 (2015).
    • 72. Tentori L, Lacal PM, Muzi A et al. Poly(ADP-ribose) polymerase (PARP) inhibition or PARP-1 gene deletion reduces angiogenesis. Eur. J. Cancer 43(14), 2124–2133 (2007).
    • 73. Liu JF, Barry WT, Birrer M et al. Combination cediranib and olaparib versus olaparib alone for women with recurrent platinum-sensitive ovarian cancer: a randomised Phase 2 study. Lancet Oncol. 15(11), 1207–1214 (2014).
    • 74. Moore K, Colombo N, Scambia G et al. Maintenance olaparib in patients with newly diagnosed advanced ovarian cancer. N. Engl. J. Med. 379(26), 2495–2505 (2018).
    • 75. Mirza MR, Wang J, Mau-Sørensen M et al. 953PA Phase 1 study to evaluate the safety and tolerability of bevacizumab-niraparib combination therapy and determine the recommended Phase 2 dose (RP2D) in women with platinum-sensitive epithelial ovarian cancer (ENGOT-OV24/AVANOVA1). Ann. Oncol. 28(Suppl. 5), mdx372.024–mdx372.024 (2017).
    • 76. Lu JF, Bruno R, Eppler S, Novotny W, Lum B, Gaudreault J. Clinical pharmacokinetics of bevacizumab in patients with solid tumors. Cancer Chemother. Pharmacol. 62(5), 779–786 (2008).
    • 77. Smerdel MP, Steffensen KD, Waldstrøm M, Brandslund I, Jakobsen A. The predictive value of serum VEGF in multiresistant ovarian cancer patients treated with bevacizumab. Gynecol. Oncol. 118(2), 167–171 (2010).
    • 78. Wimberger P, Chebouti I, Kasimir-Bauer S et al. Explorative investigation of vascular endothelial growth factor receptor expression in primary ovarian cancer and its clinical relevance. Gynecol. Oncol. 133(3), 467–472 (2014).
    • 79. Raja FA, Hook JM, Ledermann JA. Biomarkers in the development of anti-angiogenic therapies for ovarian cancer. Cancer Treat. Rev. 38(6), 662–672 (2012).
    • 80. Schultheis AM, Lurje G, Rhodes KE et al. Polymorphisms and clinical outcome in recurrent ovarian cancer treated with cyclophosphamide and bevacizumab. Clin. Cancer Res. 14(22), 7554–7563 (2008).
    • 81. Han ES, Burger RA, Darcy KM et al. Predictive and prognostic angiogenic markers in a gynecologic oncology group Phase II trial of bevacizumab in recurrent and persistent ovarian or peritoneal cancer. Gynecol. Oncol. 119(3), 484–490 (2010).
    • 82. Bais C, Mueller B, Brady MF et al. Tumor microvessel density as a potential predictive marker for bevacizumab benefit: GOG-0218 biomarker analyses. J. Natl Cancer Inst. 109(11), doi:10.1093/jnci/djx066 (2017).
    • 83. Backen A, Renehan AG, Clamp AR et al. The combination of circulating Ang1 and Tie2 levels predicts progression-free survival advantage in bevacizumab-treated patients with ovarian cancer. Clin. Cancer Res. 20(17), 4549–4558 (2014).
    • 84. Collinson F, Hutchinson M, Craven RA et al. Predicting response to bevacizumab in ovarian cancer: a panel of potential biomarkers informing treatment selection. Clin. Cancer Res. 19(18), 5227–5239 (2013).
    • 85. Karihtala P, Mäenpää J, Turpeenniemi-Hujanen T, Puistola U. Front-line bevacizumab in serous epithelial ovarian cancer: biomarker analysis of the FINAVAST trial. Anticancer Res. 30(3), 1001–1006 (2010).
    • 86. Boisen MK, Madsen CV, Dehlendorff C, Jakobsen A, Johansen JS, Steffensen KD. The prognostic value of plasma YKL-40 in patients with chemotherapy-resistant ovarian cancer treated with bevacizumab. Int. J. Gynecol. Cancer 26(8), 1390–1398 (2016).
    • 87. Steffensen KD, Madsen CV, Andersen RF, Waldstrøm M, Adimi P, Jakobsen A. Prognostic importance of cell-free DNA in chemotherapy resistant ovarian cancer treated with bevacizumab. Eur. J. Cancer 50(15), 2611–2618 (2014).
    • 88. Chan JK, Kiet TK, Blansit K et al. MiR-378 as a biomarker for response to anti-angiogenic treatment in ovarian cancer. Gynecol. Oncol. 133(3), 568–574 (2014).
    • 89. Norquist BM, Brady MF, Harrell MI et al. Mutations in homologous recombination genes and outcomes in ovarian carcinoma patients in GOG 218: an NRG Oncology/Gynecologic Oncology Group Study. Clin. Cancer Res. 24(4), 777 (2018).
    • 90. Ng CS, Zhang Z, Lee SI et al. CT perfusion as an early biomarker of treatment efficacy in advanced ovarian cancer: an ACRIN and GOG study. Clin. Cancer Res. 23(14), 3684–3691 (2017).
    • 91. Previs RA, Bevis KS, Huh W et al. A prognostic nomogram to predict overall survival in women with recurrent ovarian cancer treated with bevacizumab and chemotherapy. Gynecol. Oncol. 132(3), 531–536 (2014).
    • 92. Slaughter KN, Thai T, Penaroza S et al. Measurements of adiposity as clinical biomarkers for first-line bevacizumab-based chemotherapy in epithelial ovarian cancer. Gynecol. Oncol. 133(1), 11–15 (2014).
    • 93. Azad NS, Annunziata CM, Steinberg SM et al. Lack of reliability of CA125 response criteria with anti‐VEGF molecularly targeted therapy. Cancer 112(8), 1726–1732 (2008).
    • 94. Randall LM, Sill MW, Burger RA, Monk BJ, Buening B, Sorosky JI. Predictive value of serum CA-125 levels in patients with persistent or recurrent epithelial ovarian cancer or peritoneal cancer treated with bevacizumab on a Gynecologic Oncology Group Phase II trial. Gynecol. Oncol. 124(3), 563–568 (2012).
    • 95. Dao MD, Alwan LM, Gray HJ, Tamimi HK, Goff BA, Liao JB. Recurrence patterns after extended treatment with bevacizumab for ovarian, fallopian tube, and primary peritoneal cancers. Gynecol. Oncol. 130(2), 295–299 (2013).
    • 96. Mir O, Coriat R, Cabanes L et al. An observational study of bevacizumab-induced hypertension as a clinical biomarker of antitumor activity. Oncologist 16(9), 1325–1332 (2011).
    • 97. Itatani Y, Kawada K, Yamamoto T, Sakai Y. Resistance to anti-angiogenic therapy in cancer-alterations to anti-VEGF pathway. Int. J. Mol. Sci. 19(4), 1232 (2018).
    • 98. Guerrouahen BS, Pasquier J, Kaoud NA et al. Akt-activated endothelium constitutes the niche for residual disease and resistance to bevacizumab in ovarian cancer. Mol. Cancer Ther. 13(12), 3123–3136 (2014).
    • 99. Mitamura T, Pradeep S, McGuire M et al. Induction of anti-VEGF therapy resistance by upregulated expression of microseminoprotein (MSMP). Oncogene 37, 722 (2017).
    • 100. Iwai T, Sugimoto M, Harada S, Yorozu K, Kurasawa M, Yamamoto K. Continuous administration of bevacizumab plus capecitabine, even after acquired resistance to bevacizumab, restored anti-angiogenic and antitumor effect in a human colorectal cancer xenograft model. Oncol. Rep. 36(2), 626–632 (2016).