Ascites predicts treatment benefit of bevacizumab in front-line therapy of advanced epithelial XXXX : An NRG Oncology/GOG study.

@entity43 @entity1 @entity3012 @entity843 @entity10224
OBJECTIVES: Predictive factors for efficacy of bevacizumab in advanced @entity43 have remained elusive. We investigated @entity843 both as a prognostic factor and as a predictor of efficacy for bevacizumab. METHODS: Using data from GOG 0218, @entity1 receiving cytotoxic therapy plus concurrent and maintenance bevacizumab were compared to those receiving cytotoxic therapy plus placebo. The presence of @entity843 was determined prospectively. Chi-square and Wilcoxon-Mann-Whitney tests compared baseline variables between subgroups. Survival was estimated by Kaplan-Meier method, and Cox proportional hazard models were used to evaluate independent prognostic factors and estimate their covariate-adjusted effects on survival. RESULTS: Treatment arms were balanced with respect to @entity843 and other prognostic factors. Overall, 886 (80%) @entity1 had @entity843 , 221 (20%) did not. Those with @entity843 were more likely to have: poorer performance status (p<0.001); serous histology (p=0.012); higher baseline @entity10224 (p<0.001); and suboptimal cytoreduction (p=0.004). In multivariate survival analysis, @entity843 was prognostic of poor @entity3012 (Adjusted HR 1.22, 95% CI 1.00-1.48, p=0.045), but not PFS. In predictive analysis, @entity1 without @entity843 treated with bevacizumab had no significant improvement in either PFS (AHR 0.81, 95% CI 0.59-1.10, p=0.18) or @entity3012 (AHR 0.94, 95% CI 0.65-1.36, p=0.76). @entity1 with @entity843 treated with bevacizumab had significantly improved PFS (AHR 0.71, 95% CI 0.62-0.81, p<0.001) and @entity3012 (AHR 0.82, 95% CI 0.70-0.96, p=0.014). CONCLUSIONS: Ascites in @entity1 with advanced @entity43 is prognostic of poor overall survival. Ascites may predict the population of @entity1 more likely to derive long-term benefit from bevacizumab.
