462 Safety of bevacizumab therapy in elderly patients with ovarian cancer: an experience from the department of gynaecologic oncology in the university hospital centre Zagreb

Introduction Bevacizumab is a recombinant humanized monoclonal antibody to vascular endothelial growth factor. It is an effective treatment for epithelial ovarian cancer, both in primary and recurrent disease. The incidence of ovarian cancer increases with advancing age. Despite the high prevalence of the ovarian cancer in elderly, the management of these patients is often less aggressive than that in younger patients. Our aim was to investigate the safety of bevacizumab administration in patients older than 65 years. Methodology Retrospectively, we have analysed the medical data of 65 patients with epithelial ovarian, fallopian tube, or primary peritoneal cancer who started treatment with bevacizumab in primary advanced and in first relapse of the disease at the Department of Gynaecologic Oncology in the University Hospital Centre Zagreb in the period from April 2017 to December 2018. Patients are divided in two categories according to age: group 1 (>65 years) and group 2 (≤65 years). Results Our analysis included 65 patients:18 (27,7%) patients in group 1 compared with 47 (72.3%) in group 2. Bevacizumab have been administered to 38 (58.5%) patients as first-line treatment and to 27 (41.5%) patients as second-line treatment. The median age was 70 (range 66–76) years in group 1 and 55 (range 35–65) in group 2. ECOG performance status 0 had 44.7% of patients in group 2 compared with only 33.3% in group 1. At the time of diagnosis, elderly patients had presented with at least one comorbidity in 66.6% of the cases, compared with 40.4% in group 2. The median number of cycles of bevacizumab was 9 in elderly patients and 17 cycles in group 2. Among those patients receiving bevacizumab in the first-line setting, median progression free interval (PFI) was 12 months in younger patients versus 7 months in elderly patients. Similarly, among those receiving bevacizumab in the second-line setting PFI was 9 months in younger patients versus 1 months in elderly patients. The occurrence of adverse events did not increase in elderly patients; 51.1% of patients in group 2 reported some adverse events versus only 27.8% in elderly patients. Conclusion In Croatia, from February 2017 we have opportunity to treat patients with epithelial ovarian, fallopian tube, or primary peritoneal cancer with bevacizumab in the first-line and second-line settings. Our experience in treating patients with bevacizumab shows good results with acceptable toxicity and our findings suggest that its use in the elderly population should be considered as safe and manageable. Disclosures The authors have declared no conflicts of interest.