Using the agreed starting and stopping criteria, bevacizumab 7.5 mg/kg dose in combination with carboplatin and paclitaxel can continue to be made available within NHS Wales for the front-line treatment of adult patients with advanced epithelial ovarian, fallopian tube, or primary peritoneal cancer at high risk for progression. High risk is defined as: International Federation of Gynaecology and Obstetrics [FIGO] stage III debulked but residual disease more than 1.0 cm or stage IV disease, or stage III disease at presentation and requiring neoadjuvant chemotherapy due to low likelihood of optimal primary surgical cytoreduction.

Bevacizumab 7.5 mg/kg is not licensed to treat this indication and is therefore off-label. Each provider organisation must ensure all internal governance arrangements are completed before these medicines are prescribed in combination.

The risks and benefits of the off-label use of bevacizumab for this indication should be clearly stated and discussed with the patient to allow informed consent.

In June 2019 OWMAG recommended this treatment in NHS Wales, in February 2024 there was a review of the recommendation. OWMAG found nothing new that effects the original decision.

Next review: this advice will be reviewed after 12 months or earlier if new evidence becomes available.