Introduction There is still controversy or a lack of evidence regarding the efficacy of dose-dense paclitaxel plus carboplatin (ddTC) and bevacizumab (BEV) for epithelial ovarian cancer (EOC) among Japanese and Westerners. We aimed to compare the survival outcomes between conventional paclitaxel plus carboplatin (TC) with BEV and ddTC with or without BEV among Japanese.

Methods We retrospectively analyzed the data from patients newly diagnosed with EOC between 2012 and 2021 at our institutions. The target population was patients with stage III and IV EOC except for poly (adenosine diphosphate-ribose) polymerase inhibitors users. Overall survival (OS) and progression-free survival (PFS) of patients treated with ddTC and ddTC with BEV (ddTC+BEV) were compared to those of patients treated with TC with BEV (TC+BEV). We used Cox proportional hazard models adjusted for patients’ backgrounds.

Results There were 75, 259, and 117 patients treated with TC+BEV, ddTC, and ddTC+BEV, respectively. The three groups had similar backgrounds such as histopathology and staging. For PFS, adjusted hazard ratios (aHRs) [95% confidence intervals (95%CIs)] were 1.09 [0.79, 1.50] in ddTC and 0.74 [0.52, 1.08] in ddTC+BEV compared to TC+BEV. For OS, aHRs (95%CIs) were 0.89 [0.59, 1.34] in ddTC and 0.73 [0.50, 1.05] in ddTC+BEV compared to TC+BEV.

Conclusion/Implications We previously confirmed that ddTC was associated with favorable PFS and OS, and BEV could prolong PFS using the data from 1333 EOC patients at our institution. The present study further suggested that ddTC+BEV had favorable survival outcomes and might be a candidate for a clinical trial.