What is the role of bevacizumab in the treatment of cervical cancer?

Updated: Feb 12, 2019
  • Author: Cecelia H Boardman, MD; Chief Editor: Warner K Huh, MD  more...
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Answer

In a randomized study of 452 women with advanced cervical cancer (recurrent, persistent, or metastatic disease), Tewari et al reported that adding bevacizumab to combination chemotherapy prolonged survival in these women by about 3.7 months compared with chemotherapy alone (topotecan plus paclitaxel; cisplatin plus paclitaxel). [89, 90, 91, 92] Because topotecan-paclitaxel was not superior to cisplatin-paclitaxel, the data from the groups treated with these combination regimens were combined. [89, 90]

Median overall survival was 17.0 months with bevacizumab and chemotherapy, whereas it was 13.3 months with chemotherapy alone. [89, 90, 91, 92] At a median follow-up of 20.8 months, 60% of the patients died. [90] Progression-free survival was 8.2 months with bevacizumab plus chemotherapy but 5.9 months with chemotherapy alone. The response rate was 48% with bevacizumab and chemotherapy compared with 36% in the group receiving chemotherapy alone. [89, 90, 91, 92] However, the addition bevacizumab also led to an increased incidence of adverse effects such as hypertension of grade 2 or higher (25% vs 2%), thromboembolic events of grade 3 or higher (8% vs 1%), and gastrointestinal fistulas of grade 3 or higher (3% vs 0%) compared with chemotherapy alone. [89, 90]


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