Independent radiologic review: Bevacizumab in combination with gemcitabine and carboplatin in recurrent ovarian cancer

Objective. OCEANS, a randomized, placebo-controlled, phase III trial, found that adding bevacizumab to gemcitabine-carboplatin (GC) significantly improved investigator-determined progression-free survival (PFS) and objective response rate (ORR) in platinum-sensitive, recurrent ovarian cancer. To evaluate the reliability of assessment of progression and objective response per RECIST, radiologic and clinical data were assessed by an independent review committee (IRC). Methods. Radiologic images and clinical data were provided prospectively to the IRC for all randomized patients (N = 484). Data were reviewed in a blinded fashion per RECIST (modified v1.0). PFS and ORR were analyzed based on the IRC assessment. Concordance between investigator- and IRC-assessed progression and objective response was assessed. Results. The IRC analysis demonstrated a statistically significant increase in PFS (hazard ratio [HR] = 0.451; 95% confidence interval [CI] = 0.351 to 0.580, p < 0.0001) consistent with the benefit reported by investigators (HR = 0.484; 95% CI = 0388 to 0.605, p < 0.0001). The concordance rate, defined by agreement on progression status, was 74.2% overall, and comparable between treatment arms (bevacizumab, 75.2% vs. placebo, 73.1%). IRC-assessed ORR was significantly improved with bevacizumab (bevacizumab, 74.8% vs. placebo, 53.7%; p < 0.0001), consistent with the investigator-assessed results. The concordance rate for objective response was 79.8% overall, and comparable between treatment arms (bevacizumab, 78.9% vs. placebo, 80.6%). Conclusions. IRC-determined results were highly consistent with those determined by investigators, demonstrating that bevacizumab plus GC provides a significant improvement in PFS and ORR. These results suggest that investigators can reliably assess disease progression and objective response in recurrent ovarian cancer using RECIST, without the necessity of a full IRC review. (C) 2014 Elsevier Inc. All rights reserved.