Ovarian cancer (OC) is the most lethal gynecologic malignancy . In 2018, Bevacizumab was approved by FDA for use with chemotherapy as treatment for women with advanced OC.

Objective: assessing the response, survival, and toxicity of Bevacizumab in patients who used it as Neoadjuvant or adjuvant with systemic therapy compared with cases who received only post-operative chemotherapy.

Design: an interventional prospective case-control study. included patients with AOCs presented to Assiut University hospitals from 2018 until 2021.



Intervention(s): group A: 15 patients underwent primary surgical resection then received adjuvant treatment , group B: 17 patients received NACT then underwent surgical resection followed by adjuvant therapy. and control group(C): 19 patients received only post-operative chemotherapy without Bevacizumab and were reviewed retrospectively.

Primary outcome: disease free survival (DFS), and overall survival (OS).

Secondary outcome: toxicity of Bevacizumab

Results: Comparisons between groups A and B revealed no significant differences regarding DFS, OS and toxicity. At one-year post-treatment there was a significantly lower CA-125 values in patients who used Bevacizumab (A&B) than conventional chemotherapy (group C). The 3 years OS was 25% for Groups (A&B) and only 5% for Group C.

Conclusions: bevacizumab improved response rate and overall survival without significant increase in side effects. Using it as adjuvant and as neo-adjuvant produced comparable success rates: taking in consideration that the neo-adjuvant use was applied to more advanced or irresectable cases: this means that bevacizumab could give this group an outcome similar to the primarily operable cases; larger studies are needed to confirm our findings.