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What factors impact your decision to include bevacizumab with primary chemotherapy for patients with BRCA+ or HRD+ ovarian cancer?

Does your practice vary based on risk status (low vs high risk) or specific mutation status (BRCA+ vs HRD+) given PAOLA subset analyses?
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In which clinical scenarios would you be likely to include bevacizumab with primary chemotherapy for epithelial ovarian cancer?

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4 Answers
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Gynecologic Oncology · University of Oklahoma Health Sciences Center
Answered on

The decision for bev isn’t based on HRD or BRCA biomarkers – it is based on clinical factors and provider preference. Bev is approved for all epithelial ovarian cancer, advanced stage with and to follow platinum based chemotherapy based on a clinically and statistically significant improvement in PF...

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Gynecologic Oncology · Roswell Park Cancer Institute
Answered on

Because of the absence of a clear survival advantage associated with frontline concurrent and maintenance bevacizumab therapy, I generally don’t use bevacizumab with primary chemotherapy, irrespective of BRCA or HRD status. I would consider using frontline concurrent bevacizumab in BRCA+ or HRD+ pat...

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Medical Oncology · University of Utah School of Medicine
Answered on

This is a great question and one that the treating oncologist needs to ask themselves when they treat a patient with advanced high grade serous (or endometrioid) ovarian cancer. Do you think the patient will benefit from bevacizumab (recall GOG 218 trial)? If the patient has a germline or somatic BR...

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Gynecologic Oncology · John Muir Medical Center
Answered on

I do not recommend routine use of bevacizumab in the upfront setting for any patient, regardless of mutation status. The results of GOG 218 should have been enough to put an end to this practice. In addition, the HR of both SOLO1 and Paola1 trials were the same (0.3). Therefore, one may ask what, if...

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