Intraperitoneal Chemotherapy without Bevacizumab versus Intravenous Chemotherapy plus Bevacizumab as Frontline Therapy in Advanced Ovarian Cancer

Objectives: To compare the clinical outcomes between intravenous carboplatin/paclitaxel chemotherapy plus bevacizumab versus intraperitoneal cisplatin/paclitaxel chemotherapy without bevacizumab as the frontline treatment in women with advanced ovarian, fallopian tube and primary peritoneal cancer. Methods: All consecutive women with stage II~IV cancer treated with either frontline intraperitoneal cisplatin/paclitaxel without bevacizumab (IP group) or intravenous carboplatin/paclitaxel with bevacizumab (IVB group) at a tertiary referral center were reviewed. Results: A total of 59 women (IP group, n=44; IVB group, n=15) were reviewed. There was no significant difference in the progression-free survival (median: 33.6 versus 14.8 months, p=0.13). However, overall survival (OS) was significantly higher in the IP group, compared with the IVB group (median: not reached versus 31.7 months, p=0.02; adjusted hazard ratio (HR)=0.35, 95% confidence interval (CI)=0.10 to 1.07, p=0.065). Additional predictors for OS include cancer stage and the number of chemotherapy cycles. Besides, the standard dose of 100 mg/m 2 cisplatin was a predictor for OS, compared with other intraperitoneal regimens (adjusted HR=0.14, 95% CI=0.02 to 0.87, p=0.03). Conclusions: Intraperitoneal cisplatin/paclitaxel chemotherapy without bevacizumab seems to be better in OS, compared to intravenous carboplatin/paclitaxel chemotherapy with bevacizumab in the frontline treatment of women with advanced ovarian cancer.