The ICON7 trial evaluated bevacizumab in ovarian cancer. What was the key finding regarding its benefit?

• A Bevacizumab improved overall survival in all stage III/IV ovarian cancer patients
• B Bevacizumab reduced CA-125 levels by >50% compared to chemotherapy alone
• C Bevacizumab improved PFS in BRCA-mutated patients only
• D Bevacizumab improved progression-free and overall survival in high-risk patients (residual disease or stage IV) ✓

Explanation

The ICON7 trial added bevacizumab to carboplatin-paclitaxel in advanced ovarian cancer. The overall survival benefit was modest, but in the pre-specified high-risk subgroup (stage IV or stage III with residual disease >1 cm), bevacizumab demonstrated both improved PFS and an approximately 4.8-month overall survival benefit. This established the clinical role of bevacizumab in high-risk advanced disease rather than all comers. BRCA mutation status was not the selection criterion for bevacizumab (unlike PARP inhibitors).

Reference: Shaw's Textbook of Gynaecology, 17th ed.

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