Bevacizumab in first-line postoperative treatment of advanced ovarian cancer: from high-risk stratification to precision decision-making
Abstract
Bevacizumab is an important component of first-line therapy for advanced epithelial ovarian cancer; however, the precise identification of patients who will benefit and how to optimize its use in the era of poly (ADP-ribose) polymerase inhibitors (PARPi) remains a core challenge in clinical practice. This review systematically revisits the pivotal phase III trials GOG-0218 and ICON7, together with their inherent limitations, with a particular focus on the role of KELIM score as a dynamic marker of chemotherapy sensitivity in predicting bevacizumab efficacy. Based on the interaction test from GOG-0218, the available evidence suggests that BRCA/homologous recombination deficiency (HRD) status does not alter the single-agent activity of bevacizumab; however, these genetic markers remain crucial for guiding PARPi or combination regimens. A key clinical dilemma arises when patients with a BRCA mutation have already received bevacizumab during first-line chemotherapy: should bevacizumab be continued or discontinued during the maintenance phase? This review presents a preference analysis and individualized decision-making factors based on available indirect evidence and current guidelines. Finally, a clinical decision pathway that integrates KELIM assessment with HRD testing is proposed to provide an evidence-based reference framework for the rational use of bevacizumab in first-line advanced ovarian cancer.
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BibTeX
@article{zhong2026bevacizumab,
title = {{Bevacizumab in first-line postoperative treatment of advanced ovarian cancer: from high-risk stratification to precision decision-making}},
author = {Lan Zhong and Liang Song},
journal = {Frontiers in Pharmacology},
year = {2026},
month = nov,
doi = {10.3389/fphar.2026.1931140},
url = {https://www.frontiersin.org/articles/10.3389/fphar.2026.1931140},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Bevacizumab in first-line postoperative treatment of advanced ovarian cancer: from high-risk stratification to precision decision-making
AU - Lan Zhong
AU - Liang Song
PY - 2026
DA - 2026/11/09
JO - Frontiers in Pharmacology
DO - 10.3389/fphar.2026.1931140
UR - https://www.frontiersin.org/articles/10.3389/fphar.2026.1931140
AB - Bevacizumab is an important component of first-line therapy for advanced epithelial ovarian cancer; however, the precise identification of patients who will benefit and how to optimize its use in the era of poly (ADP-ribose) polymerase inhibitors (PARPi) remains a core challenge in clinical practice. This review systematically revisits the pivotal phase III trials GOG-0218 and ICON7, together with their inherent limitations, with a particular focus on the role of KELIM score as a dynamic marker of chemotherapy sensitivity in predicting bevacizumab efficacy. Based on the interaction test from GOG-0218, the available evidence suggests that BRCA/homologous recombination deficiency (HRD) status does not alter the single-agent activity of bevacizumab; however, these genetic markers remain crucial for guiding PARPi or combination regimens. A key clinical dilemma arises when patients with a BRCA mutation have already received bevacizumab during first-line chemotherapy: should bevacizumab be continued or discontinued during the maintenance phase? This review presents a preference analysis and individualized decision-making factors based on available indirect evidence and current guidelines. Finally, a clinical decision pathway that integrates KELIM assessment with HRD testing is proposed to provide an evidence-based reference framework for the rational use of bevacizumab in first-line advanced ovarian cancer.
SN - 1663-9812
ER -