How do you manage maintenance therapy in BRCA wild type patients who have undergone primary surgery and achieved an optimal/complete gross resection?

2 Answers

Mednet Member

Gynecologic Oncology · University of Colorado Denver

I do not personally utilize maintenance bevacizumab in the upfront setting for wtBRCA patients who had primary optimal resection as I do not think the small PFS benefit demonstrated in GOG 218 and ICON 7 (evaluating use of maintenance bev vs no maintenance) justifies the additional cost and morbidit...

Mednet Member

Gynecologic Oncology · University of California Irvine Medical Center

If they are wild type (i.e., no germline BRCA1/2 mutation) I would then test the tumor for somatic BRCA1/2. If that's negative and they have no contraindication to anti-angiogenesis therapy (eg., no wound healing complications after surgery, etc), I would put them on chemo plus BEV and continue BEV...