Comparison of survival outcomes of Olaparib or Olaparib combine with Bevacizumab in patients with primary high-grade serous ovarian carcinoma

Abstract This retrospective cohort study evaluated the real-world efficacy and safety of first-line maintenance therapy with Olaparib monotherapy versus Olaparib combined with Bevacizumab in patients with primary high-grade serous ovarian carcinoma (HGSOC). Among 214 eligible patients, there was no statistically significant difference in progression-free survival (PFS) or overall survival (OS) between the two treatment groups in the overall study population. However, in the biomarker-defined subgroup of patients with breast cancer susceptibility gene (BRCA) mutations, the addition of Bevacizumab to Olaparib was associated with a significant improvement in OS compared to Olaparib alone. The safety profiles of the two regimens were comparable, with no significant differences observed in the incidence of hematologic, hepatic, or renal adverse events. These findings suggest that while the combination therapy does not provide a universal survival advantage, it may offer a clinically meaningful benefit in the BRCA-mutated subset of HGSOC patients, supporting a biomarker-driven approach to maintenance treatment selection.