When would you continue bevacizumab versus using PARPi alone for maintenance therapy in BRCA+ or HRD+ ovarian cancer after response to primary platinum + bevacizumab?
Are there clinical factors which help stratify? Does your practice vary based on mutation status (BRCA+ vs HRD+?)
Answer from: at Community Practice
In patients who start treatment with combination platinum based chemotherapy + bevacizumab, and are found to be BRCA+ or HRD+, I will commonly continue bevacizumab and layer on the PARPi in the maintenance setting. This is based on both the PAOLA-1 data, as well as the population adjusted indi...
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Answer from: at Academic Institution
There is no rationale for starting bev if you aren’t going to continue it. GOG 218 clearly showed no benefit to stopping bev so outside of tox I don’t know why someone would do this.
Answer from: Medical Oncologist at Academic Institution
With high risk disease, we tend to use bevacizumab in combination with chemotherapy unless concerning risk factors exist (slow healing wound, uncontrolled hypertension, existing renal dysfunction/proteinuria, for example). If patient has germline or somatic BRCA mutation or HRD positive, we add olap...