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When prescribing bevacizumab for high-risk primary ovarian cancer, do you use 15 mg/m2 q 21 days (per GOG-0218) or 7.5 mg/m2 q 21 days (per ICON7)?

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Gynecologic Oncology · AdventHealth Cancer Institute

Interesting question. I was told once when bevacizumab was being developed by Genentech that the basic scientists predicted 5 mg/kg would saturate all the VEGF receptors in a typical adult (unconfirmed but told by someone in my remote past...I should confirm with Genentech). How 15 mg/kg was arrived...

For an optimally cytoreduced, stage III ovarian carcinosarcoma, would you offer bevacizumab maintenance after completion of adjuvant carboplatin/taxol?

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1 Answers

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Gynecologic Oncology · UCLA David Geffen School of Medicine/UCLA Medical Center

For an optimally cytoreduced patient with Stage III ovarian carcinosarcoma, I would not add bevacizumab unless the patient was "optimal" at interval surgery and had neoadjuvant and adjuvant use of bevacizumab with chemo and then to be continued in maintenance. The use of bevacizumab with chemo in th...

What pre-treatment findings on CT scan (if any) influence your concern for GI perforation risk with bevacizumab use in ovarian cancer patients?

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Gynecologic Oncology · Columbia University Medical Center

This is really a two parts question. The first question would be, do you offer bevacizumab to all your ovarian cancer patients and the second question would be what patients would you not recommend bevacizumab because of concern for bowel perforation? Based on findings from GOG218 and ICON7, I only ...

In light of GOG-252, are there any situations where IP chemotherapy would be preferable following debulking of advanced epithelial ovarian cancer?

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Medical Oncology · Harvard Medical School

In GOG-252, the control arm (arm 1) was the dose-dense Japanese GOG (JGOG) regimen, compared to two IP-based arms (arm 2, IP carboplatin, and arm 3, IP cisplatin). As stated in our OGR, interpretation of the negative results of this study is difficult for several reasons. All three arms in GOG-252 r...

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

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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...

Should women with adequately debulked ovarian cancer receive bevacizumab with chemotherapy in the adjuvant setting?

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Medical Oncology · University of Pittsburgh Magee Womens Hospital

The answer to this question is definitively NO.Two large, definitive studies (ICON-7 and GOG218 – including over 3400 patient combined) evaluated the impact of adjuvant chemotherapy with concurrent + maintenance bevacizumab. Analysis of mature data from ICON-7 demonstrated a significant overall surv...