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When would you continue bevacizumab versus using PARPi alone for maintenance therapy in BRCA+ or HRD+ ovarian cancer after response to primary platinum + bevacizumab?

3 Answers
Mednet Member
Mednet Member
Gynecologic Oncology · UCSD Moores Cancer Center

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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Mednet Member
Mednet Member
Gynecologic Oncology · University of Oklahoma Health Sciences Center

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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Mednet Member
Mednet Member
Medical Oncology · University of Utah School of Medicine

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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When would you continue bevacizumab versus using PARPi alone for maintenance therapy in BRCA+ or HRD+ ovarian cancer after response to primary platinum + bevacizumab? | Mednet