Развитие цитостатической терапии как в лечении рака яичников, так и рака шейки матки зашло в тупик, поэтому в последние годы основной поиск исследований направляется на изучение биологии данных заболеваний. Ангиогенез является одним из основных факторов микроокружения опухоли, приводящим к росту и метастазированию заболеваний. В связи с этим начали появляться препараты, ингибирующие ангиогенез. Одним из первых препаратов, изученным в III фазе рандомизированных исследований, был бевацизумаб, который продемонстрировал достоверное увеличение как выживаемости без прогрессирования, так и продолжительности жизни в группе высокого риска больных при раке яичников и при рецидивах/диссеминированных формах рака шейки матки.
The development of cytostatic therapy in the treatment of ovarian and cervical cancer has resulted in a deadlocked situation. Thus, the basic aim of the investigations was to examine the biological basis of these diseases, last years. Angiogenesis is one of the main factors of the tumor microenvironment, associated with tumor growth and metastasis. In this regard, new drugs that work by inhibiting angiogenesis have started to appear. One of the first drugs studied in randomized phase III studies was bevacizumab. The application of bevacizumab demonstrated the significant increase both in progression free-survival and life expectancy in high-risk group of patients with ovarian cancer and in patients with recurrent and advanced cervical cancer.
1. Siegel R, Naishadham D, Jemal A. Cancer statistics, 2016. CA Cancer J Clin 2016; 63: 11–30.
2. Bookman M.Trials with impact on clinical management: first line. Int J Gynecol Cancer 2009; 19 (Suppl. 2): S55–S62.
3. American Cancer Society Facts and Figures 2016.
4. Adegoke O, Kulasingam S, Virnig B. Cervical Cancer Trends in the United States: A 35-Year Population-Based Analysis. J Womens Health (Larchmt) 2012; 21 (10): 1031–7.
5. Tewari KS. Clinical implications for cediranib in advanced cervical cancer. Lancet Oncol 2015; 16 (15): 1447–8.
6. Chien J, Kuang R, Landen C, Shridhar V. Platinum-sensitive recurrence in ovarian cancer: the role of tumor microenvironment. Front Oncol 2013; 3: 251.
7. Galluzzi L, Senovilla L, Vitale I et al. Molecular mechanisms of cisplatin resistance. Oncogene 2012; 31: 1869–83.
8. Said N, Socha MJ, Olearczyk JJ et al. Motamed. Normalization of the ovarian cancer microenvironment by SPARC .Mol Cancer Res 2007; 5: 1015–30.
9. Fukumura D, Jain R.Tumor microvasculature and microenvironment: targets for anti-angiogenesis and normalization. Microvasc Res 2007; 74: 72–84.
10. Kassis J, Klominek J, Kohn EC. Tumor microenvironment: what can effusions teach us? Diagn Cytopathol 2005; 33: 316–9.
11. Leinster DA, Kulbe H, Everitt G et al. The peritoneal tumour microenvironment of high-grade serous ovarian cancer. J Pathol 2012; 227: 136–45.
12. Eskander RN, Randall LM. Bevacizumab in the treatment of ovarian cancer. Biologics 2011; 5: 1–5.
13. Folkman J. Tumor angiogenesis: therapeutic implications. N Engl J Med 1971; 285: 1182–6.
14. Ferrara N. Molecular and biological properties of vascular endothelial growth factor. J Mol Med (Berl) 1999; 77: 527–43.
15. Burger RA, Sill MW, Monk BJ et al. Phase II trial of bevacizumab in persistent or recurrent epithelial ovarian cancer or primary peritoneal cancer: a Gynecologic Oncology Group Study. J Clin Oncol 2007; 25 (33): 5165–71.
16. Cannistra SA, Matulonis UA, Penson RT et al. Phase II study of bevacizumab in patients with platinum-resistant ovarian cancer or peritoneal serous cancer. J Clin Oncol 2007; 25 (33): 5180–6.
17. Garcia A, Hirte H, Fleming G et al. Phase II clinical trial of bevacizumab and low-dose metronomic oral cyclophosphamide in recurrent ovarian cancer: a trial of the California, Chicago, and Princess Margaret Hospital phase II consortia. J Clin Oncol 2008; 26: 76–82.
18. Tillmanns TD et al. Phase II clinical trial of bevacizumab with albumin-bound paclitaxel in patients with recurrent, platinum-resistant primary epithelial ovarian or primary peritoneal carcinoma. Gynecol Oncol 2013; 128: 221–28.
19. Eskander RN, Krishnansu S. Incorporation of anti-angiogenesis therapy in the management of advanced ovarian carcinoma – Mechanistics, review of phase III randomized clinical trials, and regulatory implications. Gynecol Oncol 2014; 132 (2): 496–505.
20. Huichung Tina Ling et al. A phase II trial on the combination of bevacizumab and irinotecan in recurrent ovarian cancer. ASCO 2014. Abst. 5564
21. Sjoquist KM et al. The REZOLVE phase II trial to evaluate the safety and potential palliative benefit of intraperitoneal bevacizumab in patients with symptomatic ascites due to advanced, chemotherapy-resistant ovarian cancer. ASCO 2014. Abst. TPS5627.
22. Aghajanian C, Blank SV, Goff BA et al. OCEANS: a randomized, double-blind, placebo-controlled phase III trial of chemotherapy with or without bevacizumab in patients with platinum-sensitive recurrent epithelial ovarian, primary peritoneal, or fallopian tube cancer. J Clin Oncol 2012; 30: 2039–45.
23. Pujade-Lauraine EFH, Weber B, Reuss A et al. AURELIA: a randomized phase III trial evaluating bevacizumab (BEV) plus chemotherapy (CT) for platinum (PT)-resistant recurrent ovarian cancer (OC). J Clin Oncol 2012; 30 [Suppl.; abstr LBA5002].
24. Witteveen ALP, Fehm T, Poveda A et al. Final overall survival (OS) results from AURELIA, an open-label randomised phase IIItrial of chemotherapy (CT) with or without bevacizumab (BEV) for platinumresistant recurrent ovarian cancer (OC). Eur J Cancer 2013; 49 (Suppl. 3) LBA 5.
25. Lauraine E, Hilpert F, Weber B et al. AURELIA: A randomized phase III trial evaluating bevacizumab (BEV) plus chemotherapy (CT) for platinum (PT)-resistant recurrent ovarian cancer (OC) J Clin Oncol 2012;30 (Suppl; abstr LBA5002).
26. Burger RA, Brady MF, Bookman MA et al. Incorporation of bevacizumab in the primary treatment of ovarian cancer. N Engl J Med 2011; 365: 2473–83.
27. Burger R, Bookman M, Monk B et al. Prospective investigation of risk factors for gastrointestinal adverse events in a phase III randomized trial of bevacizumab in first-line therapy of advanced epithelial ovarian cancer, primary peritoneal cancer or fallopian tube cancer: a Gynecologic Oncology Group study. Gynecol Oncol 2011; 120: S5.
28. Perren TJ, Swart AM, Pfisterer J et al. A phase 3 trial of bevacizumab in ovarian cancer. N Engl J Med 2011; 365: 2484–96.
29. Oza AM, Swart AM, Schröder W et al. ICON7: final overall survival results in the GCIG phase III randomized trial of bevacizumab in women with newly diagnosed ovarian cancer. Eur J Cancer 2013; 49 (Suppl. 3).
30. Wright JD, Viviano D, Powell MA et al. Bevacizumab combination therapy in heavily pretreated, recurrent cervical cancer. Gynecol Oncol 2006; 103 (2): 489–93.
31. Monk BJ, Still MW, Burger RA et al. Phase II trial of bevacizumab in the treatment of persistent or recurrent squamous cell carcinoma of the cervix: a gynecologic oncology group study. J Clin Oncol 2009; 27 (7): 1069–74.
32. Zighelboim I, Wright JD, Feng Gaoc F et al. Multicenter phase II trial of topotecan, cisplatin and bevacizumab for recurrent or persistent cervical cancer. Gynecol Oncol 2013; 130 (1): 64–8.
33. Tewari KS, Sill MW, Long HJ 3rd et al. Improved survival with bevacizumab in advanced cervical cancer. N Engl J Med 2014; 370 (8): 734–43.
34. Penson RT, Huang HQ, Wenzel LB et al. Bevacizumab for advanced cervical cancer: patient- reported outcomes of a randomized, phase 3 trial (NRG Oncology-Gynecologic Oncology Group protocol 240). Lancet Oncol 2015; 16 (3): 301–11.
35. Bevacizumab [package insert]. Genetech, Inc, San Francisco, CA.
36. Mourad JJ, des Guetz G, Debbabi H et al. Blood pressure rise following angiogenesis inhibition by bevacizumab. A crucial role for microcirculation. Ann Oncol 2008; 19 (5): 927–34.
37. Stone RL, Sood AK, Coleman RL. Collateral damage: toxic effects of targeted antiangiogenic therapies in ovarian cancer. Lancet Oncol 2010; 11 (5): 465–75.
38. Pereg D, Lishner M. Bevacizumab treatment for cancer patients with cardiovascular disease: a double edged sword? Eur Heart J 2008; 29 (19): 2325–6.
39. Hapani S, Chu D, Wu S. Risk of gastrointestinal perforation in patients with cancer treated with bevacizumab: a meta-analysis. Lancet Oncol 2009; 10 (6): 559–68.
40. Gordon CR, Rojavin Y, Patel M et al. A review on bevacizumab and surgical wound healing: an important warning to all surgeons. Ann Plast Surg 2009; 62 (6): 707–9.
41. Scappaticci FA, Fehrenbach L, Cartwright T et al. Surgical wound healing complications in metastatic colorectal cancer patients treated with bevacizumab. J Surg Oncol 2005; 91 (3): 173–80.
42. Clark AJ, Butowski NA, Chang SM et al. Impact of bevacizumab chemotherapy on craniotomy wound healing. J Neurosurg 2011; 114 (6): 1609–16.
________________________________________________
1. Siegel R, Naishadham D, Jemal A. Cancer statistics, 2016. CA Cancer J Clin 2016; 63: 11–30.
2. Bookman M.Trials with impact on clinical management: first line. Int J Gynecol Cancer 2009; 19 (Suppl. 2): S55–S62.
3. American Cancer Society Facts and Figures 2016.
4. Adegoke O, Kulasingam S, Virnig B. Cervical Cancer Trends in the United States: A 35-Year Population-Based Analysis. J Womens Health (Larchmt) 2012; 21 (10): 1031–7.
5. Tewari KS. Clinical implications for cediranib in advanced cervical cancer. Lancet Oncol 2015; 16 (15): 1447–8.
6. Chien J, Kuang R, Landen C, Shridhar V. Platinum-sensitive recurrence in ovarian cancer: the role of tumor microenvironment. Front Oncol 2013; 3: 251.
7. Galluzzi L, Senovilla L, Vitale I et al. Molecular mechanisms of cisplatin resistance. Oncogene 2012; 31: 1869–83.
8. Said N, Socha MJ, Olearczyk JJ et al. Motamed. Normalization of the ovarian cancer microenvironment by SPARC .Mol Cancer Res 2007; 5: 1015–30.
9. Fukumura D, Jain R.Tumor microvasculature and microenvironment: targets for anti-angiogenesis and normalization. Microvasc Res 2007; 74: 72–84.
10. Kassis J, Klominek J, Kohn EC. Tumor microenvironment: what can effusions teach us? Diagn Cytopathol 2005; 33: 316–9.
11. Leinster DA, Kulbe H, Everitt G et al. The peritoneal tumour microenvironment of high-grade serous ovarian cancer. J Pathol 2012; 227: 136–45.
12. Eskander RN, Randall LM. Bevacizumab in the treatment of ovarian cancer. Biologics 2011; 5: 1–5.
13. Folkman J. Tumor angiogenesis: therapeutic implications. N Engl J Med 1971; 285: 1182–6.
14. Ferrara N. Molecular and biological properties of vascular endothelial growth factor. J Mol Med (Berl) 1999; 77: 527–43.
15. Burger RA, Sill MW, Monk BJ et al. Phase II trial of bevacizumab in persistent or recurrent epithelial ovarian cancer or primary peritoneal cancer: a Gynecologic Oncology Group Study. J Clin Oncol 2007; 25 (33): 5165–71.
16. Cannistra SA, Matulonis UA, Penson RT et al. Phase II study of bevacizumab in patients with platinum-resistant ovarian cancer or peritoneal serous cancer. J Clin Oncol 2007; 25 (33): 5180–6.
17. Garcia A, Hirte H, Fleming G et al. Phase II clinical trial of bevacizumab and low-dose metronomic oral cyclophosphamide in recurrent ovarian cancer: a trial of the California, Chicago, and Princess Margaret Hospital phase II consortia. J Clin Oncol 2008; 26: 76–82.
18. Tillmanns TD et al. Phase II clinical trial of bevacizumab with albumin-bound paclitaxel in patients with recurrent, platinum-resistant primary epithelial ovarian or primary peritoneal carcinoma. Gynecol Oncol 2013; 128: 221–28.
19. Eskander RN, Krishnansu S. Incorporation of anti-angiogenesis therapy in the management of advanced ovarian carcinoma – Mechanistics, review of phase III randomized clinical trials, and regulatory implications. Gynecol Oncol 2014; 132 (2): 496–505.
20. Huichung Tina Ling et al. A phase II trial on the combination of bevacizumab and irinotecan in recurrent ovarian cancer. ASCO 2014. Abst. 5564
21. Sjoquist KM et al. The REZOLVE phase II trial to evaluate the safety and potential palliative benefit of intraperitoneal bevacizumab in patients with symptomatic ascites due to advanced, chemotherapy-resistant ovarian cancer. ASCO 2014. Abst. TPS5627.
22. Aghajanian C, Blank SV, Goff BA et al. OCEANS: a randomized, double-blind, placebo-controlled phase III trial of chemotherapy with or without bevacizumab in patients with platinum-sensitive recurrent epithelial ovarian, primary peritoneal, or fallopian tube cancer. J Clin Oncol 2012; 30: 2039–45.
23. Pujade-Lauraine EFH, Weber B, Reuss A et al. AURELIA: a randomized phase III trial evaluating bevacizumab (BEV) plus chemotherapy (CT) for platinum (PT)-resistant recurrent ovarian cancer (OC). J Clin Oncol 2012; 30 [Suppl.; abstr LBA5002].
24. Witteveen ALP, Fehm T, Poveda A et al. Final overall survival (OS) results from AURELIA, an open-label randomised phase IIItrial of chemotherapy (CT) with or without bevacizumab (BEV) for platinumresistant recurrent ovarian cancer (OC). Eur J Cancer 2013; 49 (Suppl. 3) LBA 5.
25. Lauraine E, Hilpert F, Weber B et al. AURELIA: A randomized phase III trial evaluating bevacizumab (BEV) plus chemotherapy (CT) for platinum (PT)-resistant recurrent ovarian cancer (OC) J Clin Oncol 2012;30 (Suppl; abstr LBA5002).
26. Burger RA, Brady MF, Bookman MA et al. Incorporation of bevacizumab in the primary treatment of ovarian cancer. N Engl J Med 2011; 365: 2473–83.
27. Burger R, Bookman M, Monk B et al. Prospective investigation of risk factors for gastrointestinal adverse events in a phase III randomized trial of bevacizumab in first-line therapy of advanced epithelial ovarian cancer, primary peritoneal cancer or fallopian tube cancer: a Gynecologic Oncology Group study. Gynecol Oncol 2011; 120: S5.
28. Perren TJ, Swart AM, Pfisterer J et al. A phase 3 trial of bevacizumab in ovarian cancer. N Engl J Med 2011; 365: 2484–96.
29. Oza AM, Swart AM, Schröder W et al. ICON7: final overall survival results in the GCIG phase III randomized trial of bevacizumab in women with newly diagnosed ovarian cancer. Eur J Cancer 2013; 49 (Suppl. 3).
30. Wright JD, Viviano D, Powell MA et al. Bevacizumab combination therapy in heavily pretreated, recurrent cervical cancer. Gynecol Oncol 2006; 103 (2): 489–93.
31. Monk BJ, Still MW, Burger RA et al. Phase II trial of bevacizumab in the treatment of persistent or recurrent squamous cell carcinoma of the cervix: a gynecologic oncology group study. J Clin Oncol 2009; 27 (7): 1069–74.
32. Zighelboim I, Wright JD, Feng Gaoc F et al. Multicenter phase II trial of topotecan, cisplatin and bevacizumab for recurrent or persistent cervical cancer. Gynecol Oncol 2013; 130 (1): 64–8.
33. Tewari KS, Sill MW, Long HJ 3rd et al. Improved survival with bevacizumab in advanced cervical cancer. N Engl J Med 2014; 370 (8): 734–43.
34. Penson RT, Huang HQ, Wenzel LB et al. Bevacizumab for advanced cervical cancer: patient- reported outcomes of a randomized, phase 3 trial (NRG Oncology-Gynecologic Oncology Group protocol 240). Lancet Oncol 2015; 16 (3): 301–11.
35. Bevacizumab [package insert]. Genetech, Inc, San Francisco, CA.
36. Mourad JJ, des Guetz G, Debbabi H et al. Blood pressure rise following angiogenesis inhibition by bevacizumab. A crucial role for microcirculation. Ann Oncol 2008; 19 (5): 927–34.
37. Stone RL, Sood AK, Coleman RL. Collateral damage: toxic effects of targeted antiangiogenic therapies in ovarian cancer. Lancet Oncol 2010; 11 (5): 465–75.
38. Pereg D, Lishner M. Bevacizumab treatment for cancer patients with cardiovascular disease: a double edged sword? Eur Heart J 2008; 29 (19): 2325–6.
39. Hapani S, Chu D, Wu S. Risk of gastrointestinal perforation in patients with cancer treated with bevacizumab: a meta-analysis. Lancet Oncol 2009; 10 (6): 559–68.
40. Gordon CR, Rojavin Y, Patel M et al. A review on bevacizumab and surgical wound healing: an important warning to all surgeons. Ann Plast Surg 2009; 62 (6): 707–9.
41. Scappaticci FA, Fehrenbach L, Cartwright T et al. Surgical wound healing complications in metastatic colorectal cancer patients treated with bevacizumab. J Surg Oncol 2005; 91 (3): 173–80.
42. Clark AJ, Butowski NA, Chang SM et al. Impact of bevacizumab chemotherapy on craniotomy wound healing. J Neurosurg 2011; 114 (6): 1609–16.
Авторы
С.В.Хохлова*
ФГБУ «Российский онкологический научный центр им. Н.Н.Блохина» Минздрава России. 115478, Россия, Москва, Каширское ш., д. 23
*svkhokhlova@mail.ru
________________________________________________
S.V.Khokhlova*
N.N.Blokhin Russian Cancer Research Center of the Ministry of Health of the Russian Federation. 115478, Russian Federation, Moscow, Kashirskoe sh., d. 23
*svkhokhlova@mail.ru