Would you consider IP chemotherapy in a BRCA positive advanced ovarian cancer patient after upfront ovarian debulking surgery to no gross residual?

There are at least two literature sources (Naumann et al 2018 Gynecol Oncol most recently) suggesting improved survival in patients with BRCA mutations undergoing IP therapy, consistent with observations that mutated patients are more platinum sensitive. Dose intensification of platinum should therefore improve outcomes in this population.

Strictly speaking, GOG 252 should not be cited as showing IP therapy not superior to IV therapy, as most patients also received bevacizumab. Furthermore, Tewari et al. recently reported that bevacizumab does not improve outcomes in carbo/paclitaxel treated patients who have BRCA mutations (Tewari et al , JCO 2019). This finding is also consistent with the general understanding that BRCA-mutation patients ...

SOLO1 showed significant benefit with maintenance PARP inhibitor in BRCAm patients, while GOG252 failed to confirm the benefit of IP chemo.