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I have a question, and I know you ladies will have the answers.

I know that once we finish our chemo regime we will go onto an oral maintenance dose but do we in Canada also do Avastin IV for another 15 weeks?  Seems like this is the Gold standard in the US so I was wondering if it was the same here as I haven't heard about this yet.  Trying to plan for the next part of my journey…..

thanks Teal sisters🙏🏻

@LeslieA thank you.🙏🏻 

Hi Meinvan,

When I finished my frontline chemo in November 2023 I was offered Avastin maintenance. I am in Montreal, I know things vary from province to province. At the time, my oncologist told me I could start the Avastin maintenance therapy I don't remember how long it would have been for. Either way at the time , with the advice from my dr I decided to take the " wait and see approach"

I remember my dr saying at the time she wanted to save/spare my bone marrow. Certainly a frightening time to be at the end of therapy and have the security blanket taken away.

I remember thinking, maybe I take it, maybe I will develop resistance to it, and then be with less options. I have not used it, but would if I ever have to. I hope I never need it.

Has your team mentioned it or offered it to you? Perhaps bring it up with them. 

@melissa thanks for the info.  I haven't had the end of treatment discussion yet with my oncologist but I will definitely ask when it does come up.  Tough decisions to do or don't.

@Teal Girl good to know. Trying to prepare and plan the next chapter

@Meinvan In a recent article I read, through there is increasing evidence for the positive effect of Bevacizumab, it is not widely prescribed. There is benefit adding it to PARPinh if you have serous cell OC. For me with clear cell, it is the only drug for any kind of maintenance. So, I argued for it. Therefore, I advice you to ask your oncologist about that and if denied ask for specific reasoning.
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@Tanja, thanks for the info.  I think from my medical notes she will offer me niraparib when I am done treatment, don't know the rationale for which drug they choose per patient.  I have high grade serous.

@Meinvan I'm certainly not a medical professional however my understanding is oral maintenance is driven by a number of factors including the patient's response to initial treatments, the presence of specific genetic mutations e.g., BRCA-1 or 2, and the type of chemotherapy regime. I am BRCA-2 positive and was a candidate based on my response to my chemo, for Lynparza (Olaparib). I'm almost a year into my two years of being able to take it (right now it's only approved in Canada for two years and that's only if your body responds well to it and you don't have a breakthrough recurrence while using it). I don't know anything about Avastin IV nor was it offered to me or mentioned to me.

Maintenance is definitely a topic for conversation with your medical team so you can understand what the next step is relative to your personal situation.

@Alwayslearning thank you.  Yes I will talk to the team when they discuss post treatment plans,  I'm just curious and like to have info prior to going in so I can ask the questions in case there are other options available, and what the rationale is for one treatment over another.  On another note what happens when your 2 years on the oral drugs is completed?

@Meinvan ... knowledge is power and I am with you 100% in gathering information. 

As for the what happens at the two year mark...that's a great question. What I've been told is that past studies do not support use of Lynparza in Canada beyond two years as the continued efficacy is not proven AND the risk of other blood cancers (a nasty side effect of the drug) increases. Having said that, I also know that a year is a long time away. There is always continuing research and discoveries. I follow a Facebook group and there are people in other countries who've been on it for 10+ years who are part of a long term study and the results of that study are supposed to be released this October. So, I like to believe that there may be a change in thinking and/or something new available. Time will tell. 

@Alwayslearning yes, I agree research is always evolving and I'm hopeful we can all live a very long time with these advancements.  Fingers and toes crossed