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NCCN Guidelines Insights: Ovarian Cancer, Version 1.2019

Featured Updates to the NCCN Guidelines

Deborah K. Armstrong, Ronald D. Alvarez, Jamie N. Bakkum-Gamez, Lisa Barroilhet, Kian Behbakht, Andrew Berchuck, Jonathan S. Berek, Lee-may Chen, Mihaela Cristea, Marie DeRosa, Adam C. ElNaggar, David M. Gershenson, Heidi J. Gray, Ardeshir Hakam, Angela Jain, Carolyn Johnston, Charles A. Leath III, Joyce Liu, Haider Mahdi, Daniela Matei, Michael McHale, Karen McLean, David M. O’Malley, Richard T. Penson, Sanja Percac-Lima, Elena Ratner, Steven W. Remmenga, Paul Sabbatini, Theresa L. Werner, Emese Zsiros, Jennifer L. Burns, and Anita M. Engh

treated with an NACT approach ( supplemental eTable 3 ), including all of the intravenous regimens recommended for conventional treatment of stage II–IV disease (ie, PDS followed by chemotherapy). Bevacizumab-Containing Regimens for Patients Treated With

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Amy Zhou, Manik Amin, Kathryn J. Fowler, Elizabeth M. Brunt, Jesse Keller, and Benjamin Tan

, but prompted consideration for treatment with an EGFR inhibitor. She was subsequently started on erlotinib, an anti-EGFR small tyrosine kinase inhibitor, at 150 mg orally daily and bevacizumab at 15 mg/kg intravenously every 3 weeks. She tolerated

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Ryan D. Gentzler and Jyoti D. Patel

, visit ). 2 Histology has also become particularly relevant for treatment decisions, and patients with squamous histology NSCLC are not eligible for treatment with pemetrexed or bevacizumab, 2 key drugs that will be discussed in detail. For

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Christopher Nevala-Plagemann, Siddharth Iyengar, Andrew D. Trunk, Lisa Pappas, Benjamin Haaland, and Ignacio Garrido-Laguna

patients who develop or present with metastatic CRC (mCRC) remain poor. Several targeted therapies have been approved by the FDA for use in the management of RAS/RAF wild-type (WT) mCRC. These agents include bevacizumab, a monoclonal antibody targeting

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Steven S. Brem, Philip J. Bierman, Henry Brem, Nicholas Butowski, Marc C. Chamberlain, Ennio A. Chiocca, Lisa M. DeAngelis, Robert A. Fenstermaker, Allan Friedman, Mark R. Gilbert, Deneen Hesser, Larry Junck, Gerald P. Linette, Jay S. Loeffler, Moshe H. Maor, Madison Michael, Paul L. Moots, Tara Morrison, Maciej Mrugala, Louis Burt Nabors, Herbert B. Newton, Jana Portnow, Jeffrey J. Raizer, Lawrence Recht, Dennis C. Shrieve, Allen K. Sills Jr, Frank D. Vrionis, and Patrick Y. Wen

-line or salvage chemotherapy include combination PCV, 40 cyclophosphamide, 41 and platinum-based regimens. 42 Anaplastic gliomas may also be treated by irinotecan 43 or etoposide. 44 Bevacizumab, an antiangiogenic agent, received accelerated approval

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Al B. Benson III, J. Pablo Arnoletti, Tanios Bekaii-Saab, Emily Chan, Yi-Jen Chen, Michael A. Choti, Harry S. Cooper, Raza A. Dilawari, Paul F. Engstrom, Peter C. Enzinger, James W. Fleshman Jr., Charles S. Fuchs, Jean L. Grem, James A. Knol, Lucille A. Leong, Edward Lin, Kilian Salerno May, Mary F. Mulcahy, Kate Murphy, Eric Rohren, David P. Ryan, Leonard Saltz, Sunil Sharma, David Shibata, John M. Skibber, William Small Jr., Constantinos T. Sofocleous, Alan P. Venook, and Christopher Willett

bevacizumab, cetuximab, panitumumab, or irinotecan in adjuvant therapy for nonmetastatic disease outside the setting of a clinical trial. Adenocarcinomas of the small bowel or appendix, for which no NCCN Guidelines exist, may be treated with systemic

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Matthew A. Gubens and Marianne Davies

and squamous cell carcinoma (SCC), as the panel’s preferred first-line option (category 1) when PD-L1 expression is ≥50%. Chemotherapy + pembrolizumab (or atezolizumab + bevacizumab) is also a category 1 recommendation suitable for select patients with

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Justine Lequesne, Florence Joly, Julien Peron, Isabelle Ray-Coquard, Anne-Claire Hardy-Bessard, Frédéric Selle, Dominique Berton, Philippe Follana, Michel Fabbro, Alain Lortholary, Eric Pujade-Lauraine, Sophie Lefèvre-Arbogast, and Elodie Coquan

-label phase III trial designed to assess the efficacy of bevacizumab in addition to palliative chemotherapy for patients with PROC. 11 Methods Data Source In the AURELIA study, 361 patients were randomly assigned to receive chemotherapy either

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Angela Jain, Paula D. Ryan, and Michael V. Seiden

oxaliplatin (FOLFOX) with bevacizumab. Before the start of treatment, evaluation of tumor markers was notable for a carcinoembryonic antigen (CEA), alfa-feto-protein (AFP), and CA-125 levels of 644, 5149, and 16, respectively. After 6 treatments, CEA levels

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Jean L. Grem

also be used for palliation in the setting of obstruction or bleeding. A concern has been the risk of perforation of the primary tumor with the use of bevacizumab-containing therapy. National Surgical Adjuvant Breast and Bowel Project (NSABP) protocol