View article

Downloaded from ascopubs. org by Utrecht Univ Lib on November 4, 2016 from 143.121. 237.084 Copyright© 2016 American Society of Clinical Oncology. All rights reserved. v 14.1 months with chemotherapy alone) and 1.09 (95% CI, 0.72 to 1.67) for topotecan (median, 13.8 v 13.3 months). However, a more pronounced treatment effect on OS was seen in the paclitaxel cohort (unadjusted HR, 0.65; 95% CI, 0.42 to 1.02; median 22.4 v 13.2 months; Fig 1 B). The extent of cross-over to bevacizumab from chemotherapy alone was similar in the three chemotherapy cohorts (paclitaxel, 38%; PLD, 39%; topotecan, 41%). These findings, albeit generated in exploratory analyses of small subgroups, generate two questions. First, are there differences in the activity of the three chemotherapy regimens in PROC? And, second, is there an optimal chemotherapy partner for bevacizumab in PROC? In the chemotherapy-only arm, numbers of PFS events, median PFS, and ORR seemed to differ between cohorts. Topotecan, typically given weekly, seemed less active than weekly paclitaxel, with intermediate results for PLD. This observation is aligned with data suggesting suboptimal efficacy of weekly topotecan, 3 whereas weekly paclitaxel induces high ORRs but disappointing PFS. 4-6 However, median OS with chemotherapy alone was similar between cohorts and consistent with historical data.