Real-world bevacizumab utilization and outcomes among women with ovarian cancer in Europe and the United States

Objective: To investigate real-world utilization of bevacizumab and treatment outcomes in patients with advanced ovarian cancer (OC) in Europe (EU5 - France, Germany, Italy, Spain, United Kingdom) and the United States (US). Methods: Data were derived from the Advanced Ovarian Cancer Disease Specific Programme (TM) - a point-in-time, independent survey conducted between November 2017-March 2018. Physicians provided data for 8 consecutive eligible patients; patients were included if their first-line (1L) treatment consisted of chemotherapy with no maintenance (chemotherapy only) or chemotherapy plus bevacizumab and bevacizumab maintenance (chemotherapy + bevacizumab). All analyses were descriptive. Results: Data on 1498 patients were analysed. At 1L, 82% received chemotherapy only and 18% received chemotherapy + bevacizumab; 63% had completed 1L, of which 38% were BReast CAncer (BRCA) gene wildtype. Bevacizumab was used by 20% of US patients and 11% of EU5 patients. Patients who received 1L chemotherapy + bevacizumab were more likely to have tumour response (96% vs 79%), be platinum sensitive (58% vs 35%) and initiate platinum chemotherapy at second-line (2L) (72% vs 58%) compared with patients who received chemotherapy only. Treatment response (85% vs 83%) and platinum sensitivity (51% vs 40%) were similar in patients with BRCA wildtype compared with the total study population. Benefits observed with chemotherapy + bevacizumab compared to chemotherapy alone were consistent, regardless of BRCA status. Conclusion: Despite the benefits observed with 1L chemotherapy + bevacizumab, relatively low proportions of patients received this regimen and treatment patterns between the US and EU5 were not uniform, in part due to differences in timings of approvals and reimbursement across territories.