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Bevacizumab, Carboplatin and Paclitaxel Combination Treatment in Advanced Stage Ovarian Cancer: The First Experience in Thammasat University Hospital, Thailand: A Case Report

Komsun Suwannarurk MD*, Yudthadej Thaweekul MD*, Karicha Mairaing MD*, Yenrudee Poomtavorn MD*, Kaan Tangtiang MD**, Wichet Piyawang MD**, Kornkarn Bhamarapravatana PhD***

Affiliation : The abstract of this manuscript was presented on April 12-15, 2015 as a poster presentation at the RCOG World Congress 2015, Joint RCOG/RANZCOG Event, Brisbane, Australia * Gynaecological Oncology Unit, Department of Obstetrics and Gynaecology, Faculty of Medicine, Thammasat University, Pathumthani, Thailand ** Department of Radiology, Faculty of Medicine, Thammasat University, Pathumthani, Thailand *** Department of Preclinical Science, Faculty of Medicine, Thammasat University, Pathumthani, Thailand

Background : Bevacizumab, a humanized monoclonal antibody targeting vascular endothelial growth factor (VEGF), has been approved for concurrent treatment with first line chemotherapy in advanced epithelial ovarian cancer. Case Report: A case of an advanced stage epithelial ovarian cancer (EOC) receiving a combination of bevacizumab, carboplatin and paclitaxel chemotherapy was reported. A 44-year-old woman was presented with abdominal discomfort and distention for 4 months. Bilateral 12 cm diameter ovarian tumors were diagnosed as FIGO stage IIIc after surgical staging operation. Histopathology report showed the mixed type of serous and endometriod adenocarcinoma. The patient was then started on carboplatin/paclitaxel combination chemotherapy for 6 cycles after surgery every 3 weeks. Bevacizumab (7.5 mg/ m2) was concurrently administered with chemotherapy every 3 weeks starting from the 2nd cycle. A complete remission was achieved after the end of the chemotherapy treatment. Bevacizumab was continued for one year after the completion of the standard chemotherapy. Bone marrow suppression, hypertension and proteinuria were not found during Bevacizumab treatment. At bevacizumab treatment completion, a platinum-sensitive recurrent ovarian cancer was diagnosed at the two weeks post program routine check-up. The patient was counseled to start second line chemotherapy treatment and has yet to come back with her decision.
Conclusion : Combination of bevacizumab, carboplatin and paclitaxel for first line chemotherapy in advanced EOC in this case had no serious side effects and need further study.

Keywords : Ovarian cancer, Bevacizumab, Carboplatin, Paclitaxel


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