When would you continue bevacizumab versus using PARPi alone for maintenance therapy in BRCA+ or HRD+ ovarian cancer after response to primary platinum + bevacizumab?
What maintenance treatment would you offer to a patient with stage III-IV BRCA+/HRD+ ovarian cancer after response to platinum + bevacizumab?
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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 indirect c...
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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.
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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...
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