A 45-year-old woman with Stage IIIC high-grade serous ovarian carcinoma undergoes optimal primary cytoreductive surgery (residual disease < 1 cm). According to ICON7/GOG-0218 trial data, the addition of bevacizumab to carboplatin-paclitaxel chemotherapy provides the greatest PFS benefit in which subgroup?
- A Stage I–II disease after complete resection
- B BRCA1-mutated tumours
- C Stage IIIC–IV high-risk disease ✓
- D Low-grade serous carcinoma
Correct answer: C. Stage IIIC–IV high-risk disease
Explanation
Both ICON7 and GOG-0218 trials showed that adding bevacizumab (anti-VEGF) to carboplatin-paclitaxel, then continuing as maintenance, improved PFS in advanced ovarian cancer. Subgroup analyses consistently showed the largest absolute PFS benefit in high-risk patients: Stage IV or Stage III with > 1 cm residual disease (ICON7 high-risk subgroup). BRCA-mutated patients derive greater benefit from PARP inhibitor maintenance rather than bevacizumab specifically.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.