Strengths and limitations
To our knowledge, this is the first real-world study to provide data on
improved OS as an advantage of BEV throughout, relative to chemotherapy
alone, in front-line therapy in advanced-stage EOC patients and the
ICON7-defined high-risk subgroup.
The prognostic factors, e.g. advanced stage, histology, pre- and
post-operative chemotherapy, and residual tumour size, were adjusted for
during multivariate analysis, but expert-patient SDM regarding BEV
utilization may possibly be influenced by choices of post-progression
therapy or socio-economic factors which were not included in our
analysis.
There are some other limitations to our study. BEV and BRCA/ homologous
recombination deficient (HRD) testing has not yet been covered by our
NHI. Hence, we are unable to provide real-world data regarding BEV in
patients with BRCA mutation/HRD. Although most AEs were mild and
treatable, the number of patients treated with BEV after prior BEV is
too small to draw a conclusion in our relapsed cohort. Further research
should be conducted to clarify these questions.