Download or read book Bevacizumab Facilitates Surgery in Previously Inoperable Patients with Low-grade Serous Ovarian Cancer: a Case Series written by Michelle Lockley and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Introduction/Background:Low grade serous ovarian cancer (LGSOC) accounts for 10% of serous epithelial ovarian cancers. In contrast to high grade serous ovarian cancer (HGSOC), it is characterised by an early age of onset, indolent growth rate and relative resistance to cytotoxic chemotherapy. The use of Bevacizumab in ovarian cancer has mostly been investigated in HGSOC and is contra-indicated in patients with extensive disease associated with the bowel, due to risks of bowel perforation. Several single-institution studies have reported activity of Bevacizumab in LGSOC in the recurrent disease or adjuvant setting. We present a case series of two patients with advanced LGSOC and extensive serosal disease involving the bowel that were treated with Bevacizumab in the first-line setting.Methodology:Case notes, pathology results and CT scans were reviewed. Histology slides from initial biopsy and debulking surgery specimens were stained for H&E to assess chemotherapy-response scores.Results:Both patients had Stage IIIC disease, with extensive disease involving the bowel which prohibited surgery. No response was seen on CT scan or serum Ca125 levels after three cycles of Carboplatin and Paclitaxel in either case, but following the addition of Bevacizumab both patients had a marked reduction in disease volume enabling debulking surgery that was not previously feasible. Serum Ca125 levels reduced to near-normal values prior to surgery following three cycles of Bevacizumab in both cases (438 to 50 and 151 to 54). There were no adverse events associated with Bevacizumab use (18 cycles 7.5mg/kg). Conclusion:We propose that Bevacizumab is safe to use in our set of LGSOC patients with extensive bowel involvement, and can facilitate surgery in those patients that were previously inoperable. Further evaluation of its use in the first line setting, particularly in patients that have had no response to conventional chemotherapy agents, is recommended. We have commenced an observational study including all LGSOC patients receiving Bevacizumab.