Background: Over 1700 new cases of ovarian cancer are diagnosed each year in Australia; 51% will not survive beyond 5 years. Most cases are epithelial ovarian cancer (EOC); standard of care treatment involves cytoreductive surgery and chemotherapy with or without bevacizumab. Bevacizumab was shown to improve progression-free-survival in patients with advanced EOC in the ICON7 and GOG218 trials (1,2). We investigated the patterns of bevacizumab use in EOC in Australia which are currently unknown.

Methods: Data for all patients with EOC diagnosed between January 2020-December 2023 were extracted from the National Gynae-Oncology Registry (NGOR). The registry collects data on diagnosis, treatment and outcomes on individuals with gynaecological malignancies from participating oncology centres around Australia. For all patients who received bevacizumab, data on demographics, tumour, and systemic treatments were analysed.

Results: 475 patients received bevacizumab in the first line setting. For those patients the median age was 65 years (range, 24-85) and 65% were from a metropolitan area. Most patients had a Charlson Comorbidity score of ≥3 (53%), and an ECOG performance status of ≤1 (72%). The majority had advanced disease (III, 39%; IV, 52%) and serous histology (92%). 408 patients underwent cytoreductive surgery (primary, 29%; interval, 71%), of which approx. 66% achieved optimal cytoreduction. Almost all patients (94%) received doublet platinum chemotherapy. Compared to the relevant trial populations these Australian patients were older with poorer performance status (Table 1).

Conclusion:In an Australian context, bevacizumab is predominantly used in advanced EOC, consistent with international guidelines. However, broader inclusion appeared to be applied, extending its use to patients with earlier disease stage (despite not recommended) and lower performance status. These findings highlight the importance of contextualising clinical trial evidence within local practice patterns. Survival analysis is underway to clarify real-world effectiveness of bevacizumab in this diverse population and inform clinical decision-making.