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Gynecologic Cancers
How do you manage maintenance therapy in BRCA wild type patients who have undergone primary surgery and achieved an optimal/complete gross resection?
With the recent publication of GOG252 - does this change your management for patients with ovarian cancer who undergo primary surgery who have an optimal or complete gross resection? Would you give all non-BRCA patients adjuvant carbo/taxol/bevacizumab followed by bevacizumab maintenance?
Answer from: at Academic Institution
I do not personally utilize maintenance bevacizumab in the upfront setting for wtBRCA patients who had primary optimal resection as I do not think the small PFS benefit demonstrated in GOG 218 and ICON 7 (evaluating use of maintenance bev vs no maintenance) justifies the additional cost and morbidit...
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Answer from: at Academic Institution
If they are wild type (i.e., no germline BRCA1/2 mutation) I would then test the tumor for somatic BRCA1/2. If that's negative and they have no contraindication to anti-angiogenesis therapy (eg., no wound healing complications after surgery, etc), I would put them on chemo plus BEV and continue BE...