Adding Bevacizumab to First-line Chemotherapy Benefits Selects Cases of Ovarian Cancer

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Participants in this study received either chemotherapy without additional treatment or chemotherapy with bevacizumab.
Participants in this study received either chemotherapy without additional treatment or chemotherapy with bevacizumab.

Bevacizumab in combination with first-line chemotherapy may result in better clinical outcomes in patients with epithelial ovarian cancer and elevated neutrophil-to-lymphocyte ratios; however, this combination treatment regimen was not found to be advantageous in patients with a high systemic immune inflammation index, according to a study published in Targeted Oncology.

A team of investigators from Italy conducted a multicenter, retrospective analysis to determine the impact of inflammatory responses in patients with International Federation of Gynecology and Obstetrics (FIGO) stage III to IV epithelial ovarian cancer undergoing first-line chemotherapy with or without bevacizumab.

The investigators invited 375 patients to receive either chemotherapy without additional treatment (n=301) or chemotherapy with bevacizumab (n=74). Prior to treatment, patient neutrophil-to-lymphocyte ratios, platelet-to-lymphocyte ratios, and systemic immune inflammation indexes were recorded in order to compare with progression-free survival and overall survival rates.

Results suggested that patients with a low systemic immune inflammatory index had significantly longer progression-free and overall survival rates. Neutrophil-to-lymphocyte ratios and platelet-to-lymphocyte ratios were significantly correlated with overall survival and progression-free survival, respectively.

Systemic immune inflammation index was strongly affiliated with patient prognosis in patients receiving only chemotherapy without bevacizumab. Patients with elevated neutrophil-to-lymphocyte ratios who received bevacizumab had greater progression-free and overall survival vs patients receiving only chemotherapy; however, patients with a high systemic immune inflammation index had significantly reduced rates of both progression-free and overall survival.

“Our results suggest that bevacizumab improves clinical outcome in patients with a high [neutrophil-to-lymphocyte ratio] but may be detrimental in those with a high [systemic immune inflammation index],” the authors concluded.


Farolfi A, Petrone M, Scarpi E, et al. Inflammatory indexes as prognostic and predictive factors in ovarian cancer treated with chemotherapy alone or together with bevacizumab: a multicenter, retrospective analysis by the MITO Group (MITO 24) [published online June 14, 2018]. Targ Oncol.

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