In the ICON7 trial evaluating bevacizumab in advanced ovarian cancer (Stage III–IV), bevacizumab was added to carboplatin-paclitaxel and continued as maintenance. The trial demonstrated the greatest benefit in which subgroup?
- A BRCA1/2 mutated patients
- B High-risk patients: Stage IV or Stage III with > 1 cm residual disease ✓
- C Stage IIIA patients with optimal debulking
- D All advanced ovarian cancer patients equally
Correct answer: B. High-risk patients: Stage IV or Stage III with > 1 cm residual disease
Explanation
The ICON7 trial (Perren et al., NEJM 2011) showed that bevacizumab added to standard carboplatin-paclitaxel and maintained for 12 cycles improved progression-free survival overall, but the greatest overall survival benefit was seen in the high-risk subgroup: Stage IV disease or Stage III with > 1 cm residual disease after debulking. BRCA status was not a primary stratification in ICON7. This informed the selective use of bevacizumab in high-risk advanced disease.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
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