Exploring Bevacizumab's Role in Gynecological Cancers: An Up-to-Date Narrative Review Focusing on Ovarian Cancer.

Background: The Gynecological cancers, including ovarian cancer, endometrial cancer, breast cancer, and cervical cancer, have increased in frequency lately and it is estimated that one million cases are diagnosed every year worldwide. Bevacizumab is considered one of the first anti-angiogenic therapies as it is a monoclonal antibody binding to factors essential for tumor angiogenesis. Objective: This paper aims to review the most important findings of the literature that highlight the role of bevacizumab in gynecological cancers with a special emphasis on ovarian cance. Methods: For this narrative review, an extensive literature search was conducted using Pubmed and Web of Science to collect the most important papers investigating the role of bevacizumab in gynecological cancers, such as cervical cancer, breast cancer, endometrial cancer, and ovarian cancer. Results: Results regarding its use as monotherapy or in combination with chemotherapy and other regimens will be presented. A particular focus will be held also on findings regarding its safety and potential toxicity as well as its effectiveness. Conclusion: Bevacizumab is a key agent in the treatment of all gynecological cancers especially in the case of ovarian cancer as there is extensive evidence of its efficacy as monotherapy as well as in combination with other agents, with careful patient dosing. However, future research should focus also on the investigation of its use in other gynecological cancers. Furthermore, more investigation is required regarding its use in specific subtypes of cancer, associated e.g. with specific mutations or polymorphisms, or on factors that can affect its efficiency, such as the BMI as indicated by some studies. Finally, it should be noted that though this is not a systematic review of the literature, it highlights the more important findings paving the road for future research and guidelines about the appropriate use of bevacizumab in gynecological cancers.