Reviewer’s report
Title: 
Real-World Study of Bevacizumab Treatment in Patients with Ovarian
Cancer: A Chinese single-institution study of 155 patients
Version: 
1 
Date: 
29 Jan 2023
Reviewer's report:
Zhang et al present a retrospective study evaluating the pattern, compliance,
efficacy and safety of bevacizumab in Chinese ovarian cancer patients. They
conducted a revision of 155 patients treated with Bevacizumab during 10 years
in a single Institution.
Asian countries had the largest number of incident cases (~171,000) and
mortality (~113,000) of ovarian cancer in 2020, and only a small proportion of
Asian patients were enrolled in previous clinical trials.
Moreover, differences in the histological types and prognosis of ovarian cancer
between Asian and Caucasian patients have been reported. Therefore, real-world
data for the use of bevacizumab in Asian patients are required.
In general, "real world" studies are essential because they allow validation of
data already confirmed through clinical trials.
The strengths of this type of analysis concern the more heterogeneous study
population, compared to the patients of the clinical trials that are usually highly
selective, and most of them are from Western countries.
Zhang et al confirm not only the efficacy of bevacizumab in the treatment of
ovarian cancer, regardless of the disease setting, but also the good toxicity profile
in real-world setting in line with literature data.
Although this is a well-written paper, there is some observations:
- Abstract (line 33): recurrence therapy, please explain that includes platinum
sensitive and platinum resistance.
- Abstract (lines 43-44): 13 patients discontinued, please explain if refer to first-
line or recurrence patients.
-lines 91-92-93: remove the sentence "who were in complete response (CR) or
partial response(PR) after a primary treatment"
-lines 103-107: "Real-world studies have become increasingly… real-world
studies are needed in providing evidence of efficacy in clinical practice", please
consider rephrasing in a single clearer sentence.
-line 123: "excluded from the study if they had borderline epithelial tumors",
chemotherapy for treatment of borderline tumors is not envisaged, not even the
use of bevacizumab, I don't understand why insert this clarification. Conversely,
are carcinosarcomas included in the study population? 
- lines 189-195: please enter disease stages that are not visible due to a typing
error.
-line 219: "optimally debulking", is defined as a residual tumor less than 1 cm?
-lines 230-231: please specify the interval from last bevacizumab to surgery.
-line 306: what is meant by "extensive tumor spread"?
-lines 343-344: please specify if patients received PARP inhibitor were only
BRCA mutated or not.
-line 360: please correct II-IV with III-IV
-lines 442-443: "no studies of real-world studies of bevacizumab therapy in
ovarian cancer patients in China have been published"; there is another similar
study (Real-World Study of Adding Bevacizumab to Chemotherapy for Ovarian,
Tubal, and Peritoneal Cancer as Front-Line or Relapse Therapy (ROBOT): 8-
Year Experience), please edit the sentence or justify how your study is different.
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Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
Yes
Are the methods sufficiently described to allow the study to be repeated?
Yes
Is the use of statistics and treatment of uncertainties appropriate?
Yes
Is the presentation of the work clear?
Yes
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
Yes
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