J Gynecol Oncol.
2023 Sep;34(5):e60. 10.3802/jgo.2023.34.e60.
Real-world efficacy and safety of bevacizumab single-maintenance therapy following platinum-paclitaxel chemotherapy plus bevacizumab in patients with advanced cervical cancer
- Affiliations
-
- 1Department of Gynecologic Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
- 2Department of Obstetrics and Gynecology, Mie University School of Medicine, Tsu, Japan
- 3Department of Obstetrics and Gynecology, Toyohashi Municipal Hospital, Toyohashi, Japan
- 4Department of Obstetrics and Gynecology, Toyota Memorial Hospital, Toyota, Japan
- 5Department of Obstetrics and Gynecology, Ise Red Cross Hospital, Ise, Japan
- 6Department of Obstetrics and Gynecology, Yokkaichi Municipal Hospital, Yokkaichi, Japan
- 7Department of Obstetrics and Gynecology, Kuwana City Medical Center, Kuwana, Japan
- KMID: 2552640
- DOI: http://doi.org/10.3802/jgo.2023.34.e60
Abstract
Objective
Bevacizumab maintenance therapy following platinum-based combination chemotherapy for metastatic, recurrent, or persistent cervical cancer is not recommended as standard therapy. This pilot study aimed to evaluate the efficacy and safety of bevacizumab maintenance therapy and the contribution of the platinum-free interval to the efficacy of subsequent chemotherapy for advanced cervical cancer.
Methods
We retrospectively identified 115 patients with metastatic, recurrent, or persistent cervical cancer treated with platinum-paclitaxel chemotherapy plus bevacizumab at 7 institutions between 2015 and 2020. The primary endpoints were overall survival (OS) and progression-free survival (PFS) in patients who received bevacizumab maintenance therapy and those who did not. We also analyzed the adverse events associated with bevacizumab and survival time from the start of subsequent chemotherapy in both groups.
Results
Following platinum-paclitaxel plus bevacizumab chemotherapy, 34 patients received bevacizumab maintenance therapy and 81 patients did not. Of the 115 patients, 56 received chemotherapy for subsequent relapse. Although bevacizumab maintenance therapy prolonged PFS (median of 16.0 months vs. 9.0 months, p=0.041), significant differences were not observed in OS (p=0.374). Furthermore, bevacizumab maintenance therapy did not prolong OS and PFS after the start of subsequent chemotherapy (p=0.663 and p=0.136, respectively). Bevacizumab maintenance therapy significantly increased hypertension (p=0.035) and proteinuria (p=0.005) but did not cause complications leading to death.
Conclusion
Bevacizumab single-maintenance therapy for advanced cervical cancer can be considered in selected cases, such as those with acceptable bevacizumab-related side effects. The outcomes of our study will likely contribute to decision-making regarding practical treatment strategies.
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