ArticleFrontiers in oncology2026
Survival outcomes of low-dose and high-dose bevacizumab front-line maintenance in advanced high-grade serous ovarian cancer: a propensity score-matched real-world study.
Article in Frontiers in oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The optimal dose of bevacizumab for first-line maintenance therapy in advanced ovarian high-grade serous carcinoma (HGSC) remains controversial due to the lack of head-to-head RCTs. This real-world study aimed to compare the efficacy and safety of low-dose (7.5 mg/kg every 3 weeks) and high-dose (15 mg/kg every 3 weeks) bevacizumab in this population. Methods: We retrospectively analyzed patients with FIGO stage III-IV HGSC who received first-line bevacizumab maintenance therapy between January 2018 and May 2025. To control for confounding, 1:1 propensity score matching (PSM) was performed with sensitivity analyzes varying matching variables and caliper widths. Inverse probability of treatment weighting (IPTW) was used to confirm robustness. Results: Of 964 screened, 323 were eligible (low dose 179, high dose 144); after 1:1 PSM, 258 patients were matched (129/129) with standardized differences <0.1.After matching, PFS (HR 1.11, 95% CI 0.85-1.43, P = 0.450) and OS (HR 1.07, 95% CI 0.76-1.50, P = 0.688) did not differ significantly. IPTW analysis confirmed these findings (PFS: HR 1.06, P = 0.608; OS: HR 0.99, P = 0.942). Conclusions: In patients with advanced ovarian HGSC, low-dose and high-dose bevacizumab first line maintenance showed no statistically significant difference in PFS or OS, with a favorable safety signal for the low dose regimen. However, the study was underpowered to confirm equivalence, and a clinically meaningful increase in progression risk cannot be excluded. These findings support the feasibility of low-dose bevacizumab as a first-line maintenance option, pending prospective validation.
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