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. Author manuscript; available in PMC: 2017 Sep 26.
Published in final edited form as: Future Oncol. 2015;11(6):909–922. doi: 10.2217/fon.14.276

Table 1.

Registration trials resulting in US FDA approval of bevacizumab.

Study Disease site n Eligibility
criteria
Regimen studied Outcome measure
AEs Ref.
Visual
acuity
Median PFS
(months)
Median OS
(months)
Ocular indication
Martin et al. AMD 1208 Visual acuity between 20/25 and 20/320 Ranibizumab monthly 8.0 letters gained Equivalent rates of MI, death and stroke between arms [25]
Bevacizumab monthly 8.5 letters gained

Solid tumors
Hurwitz et al. Colorectal cancer 813 ECOG PS 0–1 ILF + placebo 6.2 15. 6 Leukopenia (37%); diarrhea (32%); HTN (11%); bleeding (3%); GI perforation (1.5%) [26]
First line ILF + bev 5 mg/kg iv. Q2w 10.6 20.3
Metastatic (HR: 0.54; 95% CI: 0.45–0.66) (HR: 0.66; 95% CI: 0.54–0.81)

Giantonio et al. Colorectal cancer 829 Adv stage FOLFOX-4 + placebo 4.7 10.8 HTN (6%); emesis (10%); bleeding (3%); neuropathy (16%); thromboembolism (3%) [27]
Metastatic FOLFOX-4 + bev 10 mg/kg Q2w 7.3 13.0
Bev 10 mg/kg Q2w 2.7 N/R
(HR: 0.52; 95% CI: 0.42–0.65) (HR: 0.75; 95% CI: 0.63–0.89)

Sandler et al. Nonsquamous NSCLC 878 ECOG PS 0–1 Carbo/paclitaxel+ placebo 4.8 10.3 Leukopenia (25%); HTN (7%); proteinuria (3%); bleeding (4%) [28]
First line Carbo/paclitaxel + bev 15 mg/kg 6.4 12.3
Locally adv Metastatic Recurrent Q3w (HR: 0.65; 95% CI: 0.56–0.76) (HR: 0.80; 95% CI: 0.69–0.93)

Miller et al. Breast cancer 722 ECOG 0−1 Paclitaxel + placebo 5.8 24.8 Infection (9%); Fatigue (9%); HTN (15%); neuropathy (23%) [29]
Locally recurrent Metastatic Paclitaxel + bev 10 mg/kg Q2w 11.4 (HR: 0.42; 95% CI: 0.34–0.52) 26.5 (HR: 0.87; 95% CI: 0.72–1.05)

Friedman et al. GBM 167 KPS >70% Bev 10 mg/kg Q2w 42.6% (6 months PFS) 9.3 HTN (8%); thromboembolic disease (6%) [30]
First or second recurrence Bev 10 mg/kg Q2w + irinotecan 50.3% (6 months PFS) 8.8

Kreisl et al. GBM 48 KPS >60% Bev 10 mg/kg Q2w 16 weeks 31 weeks Thromboembolism (12.5%); HTN (4%); hypophosphatemia (4%) [31]
Recurrent (no limit on number of prior therapies) Transition to bev + irinotecan at progression 29% (6 months PFS) 57% (6 months survival)
Arm closed early due to futility

Escudier et al. Renal cell cancer 649 KPS >70% IFN-α-2a + placebo 5.4§ 21.3 Fatigue (12%); asthenia (10%); proteinuria (7%); HTN (3%); bleeding (3%) [32]
First line IFN-α-2a + bev 10 mg/kg Q2w 10.2§ 23.3
Metastatic No CNS mets (HR: 0.63; 95% CI: 0.52–0.75) (HR: 0.91; 95% CI: 0.76 –1.10)

AURELIA Ovarian cancer 361 ECOG PS 0–2 iv. paclitaxel or iv. topotecan or iv. PLD 3.4 13.3 HTN (20.1%); proteinuria (12.8%); fatigue (2.2%); GI perforation (1.7%); thromboembolic disease (3.4%) [39]
Platinum-resistant recurrence Chemo as above + bev 15 mg/kg Q3w 6.7 16.6
(HR: 0.48; 95% CI: 0.36–0.60) (HR: 0.85; 95% CI: 0.66 –1.08)

Tewari et al. Cervical cancer 452 GOG PS 0–1 Chemotherapy + placebo 5.9 13.3 Fistula (3%); HTN (2%); neutropenia (35%); thromboembolism (8%); bleeding (5%) [21]
Recurrent/ persistent or metastatic Chemotherapy + bev 15 mg/kg Q3w 8.2 17.0
(HR: 0.67; 95% CI: 0.54–0.82) (HR: 0.71; 97% CI: 0.54–0.94)

Diference between FOLFOX + placebo vs FOLFOX + bev.

Lack of a signifcant OS advantage resulted in the US FDA revoking initial approval of bevacizumab use in patients with metastatic/recurrent breast cancer.

§

Signifcantly greater than historical controls for both treatment arms (p < 0.0001).

Regulatory approval granted by the US FDA on 14 August 2014 (recurrent/persistent and metastatic cervical cancer) and on 14 November 2014 (platinum-resistant ovarian cancer).

Adv: Advanced; AE: Grade 3 or 4 adverse events on bevacizumab; AMD: Age-related macular degeneration; Bev: Bevacizumab; Carbo: Carboplatin; Chemo: Paclitaxel + cisplatin vs paclitaxel + topotecan; ECOG: Eastern Cooperative Oncology Group; FOLFOX-4: Oxaliplatin + leucovorin + fuorouracil; GBM: Glioblastoma; GI: Gastrointestinal; GOG: Gynecologic Oncology Group; HR: Hazard ratio; HTN: Hypertension; ILF: Irinotecan + fuorouracil + leucovorin; iv.: Intravenous; KPS: Karnofsky performance score; Mets: Metastases; MI: Myocardial infarction; NSCLC: Non-small-cell lung cancer; OS: Overall survival; PFS: Progression-free survival; PLD: Pegylated liposomal doxorubicin; PS: Performance status; Q2w: Every 2 weeks; Q3w: Every 3 weeks.