Tumor progression and metastatic dissemination in ovarian cancer after dose-dense or conventional paclitaxel and cisplatin plus bevacizumab.

Abstract

The efficacy of therapeutic regimens incorporating weekly or every-3-weeks paclitaxel (PTX) for ovarian cancer is debated. We investigated the addition of bevacizumab in regimens of chemotherapy with different PTX doses and schedules in preclinical models. Treatments were cisplatin (DDP) with weekly PTX (conventional), or dose-dense-equi (every other day to the conventional cumulative dose), or dose-dense-high (total dose 1.5 times higher), with or without bevacizumab. Treatment efficacy was evaluated analyzing tumor growth in different time-windows in two patient-derived ovarian cancer xenografts with different sensitivity to cisplatin. Tumor progression, metastasis and survival were studied in ovarian cancer models growing orthotopically and disseminating in the mouse peritoneal cavity. Short-term effects on cell cycle, tumor cell proliferation/apoptosis and vasculature were evaluated by flow cytometry and immunohistochemistry. PTX dose-dense (with/without DDP) was superior to the conventional scheme in a dose-dependent manner; the high efficacy was confirmed by the lower ratio of tumor to normal cells. All schemes benefited from bevacizumab, which reduced tumor vessels. However, DDP/PTX dose-dense-high (only chemotherapy) was at least as active as DDP/PTX conventional plus bevacizumab. DDP/PTX dose-dense-high plus bevacizumab was the most effective in delaying tumor progression, though it did not prolong mouse survival and the continuous treatment with bevacizumab was associated with a malignant disease. These findings indicate that the effect of bevacizumab in combination with chemotherapy may depend on the schedule-dose of the treatment and help to explain the unclear benefits after bevacizumab.

• Authors: Francesca Bizzaro, Francesca Falcetta, Elisa D'Agostini, Alessandra Decio, Lucia Minoli, Eugenio Erba, Fedro Alessandro Peccatori, Eugenio Scanziani, Nicoletta Colombo, Massimo Zucchetti, Maria Rosa Bani, Paolo Ubezio, Raffaella Giavazzi
• Journal: International journal of cancer (Int J Cancer) Vol. 143 Issue 9 Pg. 2187-2199 (11 01 2018) ISSN: 1097-0215 [Electronic] United States
• PMID: 29752717 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2018 UICC.

Chemical References

• Bevacizumab
• Paclitaxel
• Cisplatin

Topics

• Animals
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Apoptosis
• Bevacizumab (administration & dosage)
• Cell Proliferation
• Cisplatin (administration & dosage)
• Cystadenocarcinoma, Serous (drug therapy, pathology)
• Disease Progression
• Female
• Humans
• Mice
• Mice, Nude
• Ovarian Neoplasms (drug therapy, pathology)
• Paclitaxel (administration & dosage)
• Peritoneal Neoplasms (drug therapy, secondary)
• Tumor Cells, Cultured
• Xenograft Model Antitumor Assays