In the ICON7 trial, bevacizumab (anti-VEGF monoclonal antibody) was added to carboplatin-paclitaxel in ovarian cancer. The subgroup that showed the greatest overall survival benefit was:
- A High-risk patients: Stage IV or Stage III with >1 cm residual disease after debulking ✓
- B All Stage I–II epithelial ovarian cancers
- C Patients with mucinous histotype regardless of stage
- D BRCA-mutated ovarian cancers only
Explanation
In the ICON7 trial, while bevacizumab improved progression-free survival across all groups, the overall survival benefit was confined to the high-risk subgroup—Stage IV disease or Stage III with residual disease >1 cm after debulking surgery (suboptimally debulked). This high-risk subgroup had a 4.8-month improvement in overall survival. The GOG-0218 trial similarly showed PFS benefit with bevacizumab maintenance. Bevacizumab targets VEGF-A, reducing tumor angiogenesis. BRCA mutation status does not predict bevacizumab benefit; PARP inhibitor maintenance is preferred for BRCA-mutated ovarian cancer.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
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Written and medically reviewed by the StethoPrep medical team.