Recurrent cervical cancer: add-on bevacizumab to carboplatin-paclitaxel combo shows activity

  • Redondo A & al.
  • Gynecol Oncol
  • 4 Aug 2020

  • curated by Deepa Koli
  • Univadis Clinical Summaries
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Takeaway

  • Bevacizumab in combination with carboplatin+paclitaxel shows good response and acceptable toxicity.

Why this matters

  • The GOG-0240 trial showed efficacy of bevacizumab combined with a cisplatin-paclitaxel or topotecan-paclitaxel doublet in this setting; however, the carboplatin-paclitaxel combination is more widely used in routine practice.

Study design

  • Phase 2 CECILIA study of 150 patients with recurrent metastatic cervical cancer not amenable to curative surgery and/or radiotherapy received bevacizumab with paclitaxel and carboplatin.
  • Funding: F. Hoffmann-La Roche Ltd.

Key results

  • Median follow-up was 27.8 months.
  • Median bevacizumab duration was 6.7 months; 57% of patients received maintenance bevacizumab.
  • Disease progression (39%) and adverse events (34%) were the most common reasons for bevacizumab discontinuation.
  • Physician’s decision was the most common reason for discontinuing chemotherapy.
  • 11.3% of patients experienced ≥1 perforation/fistula event:
    • Gastrointestinal perforation/fistula, 4.7%; perforation in 2.0% and fistula in 2.7%.
    • Gastrointestinal-vaginal fistula, 4.0%.
    • Genitourinary fistula, 4.7%.
  • The most common grade 3/4 adverse events were neutropenia (25%), anemia (19%), and hypertension (14%). 
  • Objective response rate was 61%.
  • Median PFS was 10.9 (95% CI, 10.1-13.7) months.
  • Median OS was 25.0 (95% CI, 20.9-30.4) months.

Limitations

  • Single group, open label.