IP address.

Ovarian cancer shares an NCCN treatment algorithm with “primary peritoneal cancer” for a reason. So if anything is going to benefit from an intraperitoneal (IP) chemo approach, you'd sure think this would be it. GOG-252 randomized an epic 1560 women with stage II-IV ovarian cancer status-post maximal cytoreduction to [1] a standard IV chemo regimen of carbo/paclitaxel/bevacizumab versus [2] the same but IP carbo in place of IV carbo versus [3] IP cisplatin in place of IV carbo. Of note, bev isn’t really that standard. But the trial was designed in the heyday of bev, and the authors understandably threw it in an attempt to stay relevant. Sadly, the primary endpoint of progression-free survival was not improved with either IP regimen, even across subset analyses based on stage and degree of debulking. What’s more, toxicity and patient reported outcomes were favorable with the IV regimen. The good news is survival times across all patients were better than pretty much every comparable trial, leading the authors to question if bev is the real MVP. What we’re left wondering: when are we going to get subQ Avastin? TBL: When bev is used for advanced ovarian cancer, it should be paired with good ole’ IV carbo/Taxol. Walker, J Clin Oncol 2019


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