10 original scientific paper lib oncol. 2021;49(1):10–19 doi: 10.20471/lo.2021.49.01.02 TOLERABILITY OF BEVACIZUMAB IN ELDERLY PATIENTS WITH OVARIAN CANCER: AN EXPERIENCE FROM THE DEPARTMENT OF GYNECOLOGIC ONCOLOGY IN THE UNIVERSITY HOSPITAL CENTRE ZAGREB KRISTINA KATIĆ, VIŠNJA MATKOVIĆ, JOŠKO LEŠIN, GORAN VUJIĆ and ANTE ĆORUŠIĆ Department of Gynecologic Oncology, Clinical Department of Gynecology and Obstetrics, University Hospital Centre Zagreb, Croatia Summary Introduction: Bevacizumab is a recombinant humanized anti-VEGF monoclonal antibody. It is an efective treatment for epithelial ovarian cancer, both in primary and recurrent disease. The incidence of ovarian cancer increases with advanc- ing age. Despite the high prevalence of the ovarian cancer in elderly, the management of these patients is often less aggres- sive than in younger patients. In Croatia, from February 2017, we have opportunity to treat patients with epithelial ovarian, fallopian tube, or primary peritoneal cancer with bevacizumab in the frst-line and second-line setings. Our aim was to in- vestigate the safety of bevacizumab administration in patients older than 65 years. Methods: We have retrospectively analyzed the archive data of 65 patients with epithelial ovarian, fallopian tube, or primary peritoneal cancer who started treatment with bevacizumab in primary advanced and in frst relapse seting at the Department of Gynecologic Oncology in the University Hospital Centre Zagreb in the period from January 2017 to Decem- ber 2018. Patients were divided in two categories according to age: group 1 (≤65 years) and group 2 (>65 years). Results: Our analysis included 65 patients:47 (72.3%) patients in group 1 compared with 18 (27.7%) in group 2. Bevaci- zumab was administered to 39 (60%) patients as frst-line treatment and to 26 (40%) patients as second-line treatment. The median age was 70 years (range 66-76 years) in group 2 and 55 years (range 35-65 years) in group 1. ECOG status 0 had 44.7% of patients in group 1 compared with only 22% in group 2. At the time of diagnosis, elderly patients had presented with at least one comorbidity in 94.4% of the cases, compared with 42.6% in group 1. The median number of cycles of bevacizumab was 9 in elderly patients and 17 cycles in group 1. Among those patients receiving bevacizumab in the frst-line seting, 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 seting PFI was 9 months in younger patients versus 1 months in elderly patients. The occurrence of non-hematological adverse events did not increase in elderly patients; 51.1% of patients in group 1 reported some of non-hematological adverse events versus only 27.8% in elderly patients. Conclusion: Our experience in treating patients with bevacizumab shows good results with acceptable toxicity and our fndings suggest that its use in the elderly population should be considered as safe and manageable. KeYWorDs: ovary cancer, bevacizumab, therapy, elderly patients Corresponding author: Kristina Katić, Department of Gyneco- logic Oncology, Clinical Department of Gynecology and Obstet- rics, University Hospital Centre Zagreb, Petrova 13, 10 000 Zagreb, Croatia. e-mail: kristina.katic@kbc-zagreb.hr INTRODUCTION In recent years, ovarian cancer (OC) became the most lethal gynecologic malignancy. According to global estimates 295,414 new cases were detected in