Avastin is a vascular endothelial growth factor inhibitor indicated for the treatment of…Epithelial ovarian, fallopian tube, or primary peritoneal cancer…in combination with paclitaxel, pegylated liposomal doxorubicin, or topotecan for platinum-resistant recurrent disease who received no more than 2 prior chemotherapy regimens.

Avastin is a vascular endothelial growth factor inhibitor indicated for the treatment of… Epithelial ovarian, fallopian tube, or primary peritoneal cancer:…in combination with carboplatin and paclitaxel, followed by Avastin as a single agent, for stage III or IV disease following initial surgical resection…i in combination with carboplatin and paclitaxel or carboplatin and gemcitabine, followed by Avastin as a single agent, for platinumsensitive recurrent disease.

Bevacizumab, in combination with carboplatin and paclitaxel is indicated for the front-line treatment of adult patients with advanced…epithelial ovarian, fallopian tube, or primary peritoneal cancer.

Bevacizumab, in combination with carboplatin and gemcitabine, is indicated for treatment of adult patients with first recurrence of platinum-sensitive epithelial ovarian, fallopian tube or primary peritoneal cancer who have not received prior therapy with bevacizumab or other VEGF inhibitors or VEGF receptor–targeted agents.

Bevacizumab in combination with paclitaxel, topotecan, or pegylated liposomal doxorubicin is indicated for the treatment of adult patients with platinum-resistant recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer who received no more than two prior chemotherapy regimens and who have not received prior therapy with bevacizumab or other VEGF inhibitors or VEGF receptor–targeted agents.

Recommendations...When ICS is not possible, and in the absence of overt disease progression, three additional cycles of paclitaxel–carboplatin alone [I, A] or with bevacizumab [II, B; ESMO-MCBS v1.1 score: 4] are recommended.

Recommendations...Bevacizumab in the neoadjuvant setting, before ICS, can be considered [II, B; ESMO-Magnitude of Clinical Benefit Scale (ESMO-MCBS) v1.1 score: 4].

...the panel members feel that single-agent bevacizumab is a preferred option in patients who have recurrent disease...which is refelected in the category 2A recommendation for bevacizumab alone for women with either platinum-sensitive or platinum-resistant disease. Acceptable Recurrence Therapies for Epithelial Ovarian (including LCOC)/Fallopian Tube/Primary Peritoneal Cancer....Recurrence Therapy for Platinum-Resistant Disease….Other Recommended Regimens...Gemcitabine/bevacizumab

Ovarian cancer: Preferred regimens…Capecitabine/liposomal doxorubicin ± bevacizumab...Acceptable Recurrence Therapies for Epithelial Ovarian...Recurrence Therapy for Platinum-Sensitive Disease...Preferred Regimens...Carboplatin/paclitaxel ± bevacizumab

…the NCCN Panel added recommendations for recurrence therapy for mucinous carcinomas: 1) 5-FU/leucovorin/oxaliplatin with or without bevacizumab (category 2B for bevacizumab)…

…the NCCN Panel recommends the following combination regimens for patients-resistant recurrent ovariancancer: weekly paclitaxel/bevacizumab, liposomal doxorubicin/bevacizumab, and topotecan/bevacizumab… Primary Therapy for Stage II–IV Disease: Docetaxel/carboplatin/bevacizumab + maintenance bevacizumab (GOG-218) regimen added to Other Recommended Regimens for all disease types.

...406 patients were recruited (203 [50%] assigned to the bevacizumab group and 203 [50%] to the standard chemotherapy group)....Median progression-free survival was 8·8 months (95% CI 8·4–9·3) in the standard chemotherapy group and 11·8 months (10·8–12·9) in the bevacizumab group (hazard ratio 0·51, 95% CI 0·41–0·65; log-rank p<0·0001)....Continuing bevacizumab beyond progression combined with chemotherapy in patients with platinum-sensitive recurrent ovarian cancer improves progression-free survival compared with standard chemotherapy alone

The median progression-free survival was 10.3 months in the control group, 11.2 in the bevacizumab-initiation group, and 14.1 in the bevacizumab-throughout group....This study showed a significant improvement in progression-free survival (i.e., an increase in median progression-free survival by 4 months) with bevacizumab plus chemotherapy (with carboplatin and paclitaxel) followed by extended bevacizumab therapy, as compared with chemotherapy alone, for advanced ovarian cancer.