The following is a summary of “Identification of Patients With Ovarian Cancer Experiencing the Highest Benefit From Bevacizumab in the First-Line Setting on the Basis of Their Tumor-Intrinsic Chemosensitivity (KELIM): The GOG-0218 Validation Study” published in the December 2022 issue of Oncology by You et al.

Predictors of bevacizumab effectiveness in the first-line scenario are required in patients with high-grade ovarian cancer. An unfavorable modeled cancer antigen-125 [CA-125] ELIMination rate constant K [KELIM] score, which denotes poor tumor intrinsic chemosensitivity, served as a prognostic biomarker in the ICON-7 trial. Only those patients with high-risk illness (suboptimally resected stage III or stage IV) and unfavorable KELIM score <1.0 benefited from bevacizumab in terms of overall survival (OS) (median: 29.7 v 20.6 months; hazard ratio [HR], 0.78). The GOG-0218 trial underwent an external validation evaluation.

Carboplatin-paclitaxel with concurrent maintenance bevacizumab/placebo was administered to 1,873 patients in GOG-0218. The Lyon University researchers determined the patient’s KELIM levels throughout the course of the first 100 treatment days using CA-125 kinetics. NGR-GOG separately evaluated, using univariate/multivariate analyses, the relationship between KELIM score (favorable ≥1.0, or unfavorable <1.0) & bevacizumab benefit for progression-free survival (PFS)/OS.

With ≥3 CA-125 available results, KELIM could be evaluated in 1,662 individuals. Bevacizumab advantage over placebo was linked to an unfavorable KELIM score (PFS: HR, 0.70; 95% CI, 0.59-0.82; OS: HR, 0.87; 95% CI, 0.73 to 1.03); however, a favorable KELIM score was not (PFS: HR, 0.96; 95% CI, 0.79 to 1.17; OS: HR, 1.11; 95% CI, 0.89 to 1.39). For PFS (median: 9.1 v 5.6 months; HR, 0.64; 95% CI, 0.53 to 0.78), and OS (median: 35.1 v 29.1 months; HR, 0.79; 95% CI, 0.65 to 0.97), the greatest benefit was shown in patients with a high-risk illness demonstrating unfavorable KELIM.

Bevacizumab may primarily be effective in patients with poorly chemosensitive disease, according to the GOG-0218 trial investigation, which supported ICON-7 findings about the relationship between poor tumor chemosensitivity and benefits from concurrent-maintenance bevacizumab. To increase the PFS/OS of patients with a high-risk and poorly chemosensitive illness, bevacizumab may be given priority.