Skip to main content
Top
Published in: BMC Cancer 1/2021

Open Access 01-12-2021 | Cervical Cancer | Research article

Cisplatin plus paclitaxel chemotherapy with or without bevacizumab in postmenopausal women with previously untreated advanced cervical cancer: a retrospective study

Authors: Guanghua Chu, Xiangzhen Liu, Weiguang Yu, Meiji Chen, Lingyun Dong

Published in: BMC Cancer | Issue 1/2021

Login to get access

Abstract

Background

The aim of this study was to assess the survival outcomes of cisplatin-paclitaxel chemotherapy plus bevacizumab (CPB) versus cisplatin-paclitaxel chemotherapy alone (CPA) in postmenopausal women with previously untreated advanced cervical cancer (CC).

Methods

Consecutive postmenopausal women who experienced CPB or CPA were identified retrospectively from our medical centre during 2015–2019. Follow-up visits occurred 1 and 3 months after starting CPB or CPA. Afterwards, this assessment was conducted every 3 months for 1 year and then yearly thereafter. The primary endpoints were overall survival (OS) and progression-free survival (PFS); secondary endpoints were the frequency and severity of adverse events (AEs).

Results

Two hundred forty-six postmenopausal women were included (CPB, n = 124; CPA, n = 122). The median follow-up for the entire cohort was 24 months (range, 2–32). At the final follow-up, a significant difference was detected in terms of median OS (16.4 months [95% CI, 15.3–17.1] for CPB vs. 12.3 months [95% CI, 10.2–13.5] for CPA; hazard ratio (HR) 0.69, 95% CI, 0.49–0.99; p = 0.001), and the median PFS was longer in the CPB group than in the CPA group (9.2 months [95% CI, 8.3–10.7] vs. 7.9 months (95% CI, 6.1–8.6) (HR 0.62, 95% CI, 0.47–0.82; p < 0.001). There were significant differences in the number of AEs between the groups (hypertension grade ≥ 2 [p < 0.001], neutropenia grade ≥ 4 [p < 0.001], and thrombosis/embolism grade ≥ 3 [p = 0.030]).

Conclusions

Among postmenopausal women with previously untreated advanced CC, those who received CPB experienced superior survival benefits compared to those who received CPA. The safety profile for CPB was controllable despite the long duration of CPB use.
Literature
1.
go back to reference Tewari KS, Sill MW, Penson RT, Huang H, Ramondetta LM, Landrum LM, Oaknin A, Reid TJ, Leitao MM, Michael HE, DiSaia PJ, Copeland LJ, Creasman WT, Stehman FB, Brady MF, Burger RA, Thigpen JT, Birrer MJ, Waggoner SE, Moore DH, Look KY, Koh WJ, Monk BJ. Bevacizumab for advanced cervical cancer: final overall survival and adverse event analysis of a randomised, controlled, open-label, phase 3 trial (gynecologic oncology group 240). Lancet. 2017;390(10103):1654–63.CrossRef Tewari KS, Sill MW, Penson RT, Huang H, Ramondetta LM, Landrum LM, Oaknin A, Reid TJ, Leitao MM, Michael HE, DiSaia PJ, Copeland LJ, Creasman WT, Stehman FB, Brady MF, Burger RA, Thigpen JT, Birrer MJ, Waggoner SE, Moore DH, Look KY, Koh WJ, Monk BJ. Bevacizumab for advanced cervical cancer: final overall survival and adverse event analysis of a randomised, controlled, open-label, phase 3 trial (gynecologic oncology group 240). Lancet. 2017;390(10103):1654–63.CrossRef
2.
go back to reference Choi CH, Chung JY, Kang JH, Paik ES, Lee YY, Park W, Byeon SJ, Chung EJ, Kim BG, Hewitt SM, Bae DS. Chemoradiotherapy response prediction model by proteomic expressional profiling in patients with locally advanced cervical cancer. Gynecol Oncol. 2020;157(2):437–43.CrossRef Choi CH, Chung JY, Kang JH, Paik ES, Lee YY, Park W, Byeon SJ, Chung EJ, Kim BG, Hewitt SM, Bae DS. Chemoradiotherapy response prediction model by proteomic expressional profiling in patients with locally advanced cervical cancer. Gynecol Oncol. 2020;157(2):437–43.CrossRef
3.
go back to reference Karaman S, Leppänen VM, Alitalo K. Vascular endothelial growth factor signaling in development and disease. Development. 2018;145(14):dev151019.CrossRef Karaman S, Leppänen VM, Alitalo K. Vascular endothelial growth factor signaling in development and disease. Development. 2018;145(14):dev151019.CrossRef
4.
go back to reference Chung HC, Ros W, Delord JP, Perets R, Italiano A, Shapira-Frommer R, Manzuk L, Piha-Paul SA, Xu L, Zeigenfuss S, Pruitt SK, Leary A. Efficacy and Safety of Pembrolizumab in Previously Treated Advanced Cervical Cancer: Results From the Phase II KEYNOTE-158 Study. J Clin Oncol. 2019;37(17):1470.CrossRef Chung HC, Ros W, Delord JP, Perets R, Italiano A, Shapira-Frommer R, Manzuk L, Piha-Paul SA, Xu L, Zeigenfuss S, Pruitt SK, Leary A. Efficacy and Safety of Pembrolizumab in Previously Treated Advanced Cervical Cancer: Results From the Phase II KEYNOTE-158 Study. J Clin Oncol. 2019;37(17):1470.CrossRef
5.
go back to reference Penson RT, Huang HQ, Wenzel LB, Monk BJ, Stockman S, Long HJ, Ramondetta LM, Landrum LM, Oaknin A, Reid TJA, Leitao MM, Method M, Michael H, Tewari KS. Bevacizumab for advanced cervical cancer: patient-reported outcomes of a randomised, phase 3 trial (NRG oncology-gynecologic oncology group protocol 240). Lancet Oncol. 2015;16(3):301–11.CrossRef Penson RT, Huang HQ, Wenzel LB, Monk BJ, Stockman S, Long HJ, Ramondetta LM, Landrum LM, Oaknin A, Reid TJA, Leitao MM, Method M, Michael H, Tewari KS. Bevacizumab for advanced cervical cancer: patient-reported outcomes of a randomised, phase 3 trial (NRG oncology-gynecologic oncology group protocol 240). Lancet Oncol. 2015;16(3):301–11.CrossRef
6.
go back to reference Maluf FC, Leiser AL, Aghajanian C, Sabbatini P, Pezzulli S, Chi DS, Wolf JK, Levenback C, Loh E, Spriggs DR. Phase II study of tirapazamine plus cisplatin in patients with advanced or recurrent cervical cancer. Int J Gynecol Cancer. 2006;16(3):1165–71.CrossRef Maluf FC, Leiser AL, Aghajanian C, Sabbatini P, Pezzulli S, Chi DS, Wolf JK, Levenback C, Loh E, Spriggs DR. Phase II study of tirapazamine plus cisplatin in patients with advanced or recurrent cervical cancer. Int J Gynecol Cancer. 2006;16(3):1165–71.CrossRef
7.
go back to reference Al-Husein B, Abdalla M, Trepte M, DeRemer DL, Somanath PR. Antiangiogenic therapy for Cancer: an update. Pharmacotherapy. 2012;32(12):1095–111.CrossRef Al-Husein B, Abdalla M, Trepte M, DeRemer DL, Somanath PR. Antiangiogenic therapy for Cancer: an update. Pharmacotherapy. 2012;32(12):1095–111.CrossRef
8.
go back to reference Tewari KS, Sill MW, Long HJ, Penson RT, Huang H, Ramondetta LM, Landrum LM, Oaknin A, Reid TJ, Leitao MM, Michael HE, Monk BJ. Improved survival with Bevacizumab in advanced cervical Cancer. N Engl J Med. 2014;370(8):734–43.CrossRef Tewari KS, Sill MW, Long HJ, Penson RT, Huang H, Ramondetta LM, Landrum LM, Oaknin A, Reid TJ, Leitao MM, Michael HE, Monk BJ. Improved survival with Bevacizumab in advanced cervical Cancer. N Engl J Med. 2014;370(8):734–43.CrossRef
9.
go back to reference Kazazi-Hyseni F, Beijnen JH, Schellens JHM. Bevacizumab. Oncologist. 2010;15(8):819–25.CrossRef Kazazi-Hyseni F, Beijnen JH, Schellens JHM. Bevacizumab. Oncologist. 2010;15(8):819–25.CrossRef
10.
go back to reference Bizzarri N, Ghirardi V, Alessandri F, Venturini PL, Menada MV, Rundle S, Maggiore ULR, Ferrero S. Bevacizumab for the treatment of cervical cancer. Expert Opin Biol Ther. 2016;16(3):407–19.CrossRef Bizzarri N, Ghirardi V, Alessandri F, Venturini PL, Menada MV, Rundle S, Maggiore ULR, Ferrero S. Bevacizumab for the treatment of cervical cancer. Expert Opin Biol Ther. 2016;16(3):407–19.CrossRef
11.
go back to reference Skelton WP, Castagno J, Cardenas-Goicoechea J, Daily K, Yeung A, Markham MJ. Bevacizumab eligibility in patients with metastatic and recurrent cervical Cancer: a retrospective review. Clin Med Insights-Oncol. 2018;12:1179554918779587.CrossRef Skelton WP, Castagno J, Cardenas-Goicoechea J, Daily K, Yeung A, Markham MJ. Bevacizumab eligibility in patients with metastatic and recurrent cervical Cancer: a retrospective review. Clin Med Insights-Oncol. 2018;12:1179554918779587.CrossRef
12.
go back to reference Grigsby PW, Massad LS, Mutch DG, Powell MA, Thaker PH, McCourt C, Hagemann A, Fuh K, Kuroki L, Schwarz JK, Markovina S, Lin AJ, Dehdashti F, Siegel BA. FIGO 2018 staging criteria for cervical cancer: impact on stage migration and survival. Gynecol Oncol. 2020;157(3):639–43.CrossRef Grigsby PW, Massad LS, Mutch DG, Powell MA, Thaker PH, McCourt C, Hagemann A, Fuh K, Kuroki L, Schwarz JK, Markovina S, Lin AJ, Dehdashti F, Siegel BA. FIGO 2018 staging criteria for cervical cancer: impact on stage migration and survival. Gynecol Oncol. 2020;157(3):639–43.CrossRef
13.
go back to reference Plummer C, Michael A, Shaikh G, Stewart M, Buckley L, Miles T, Ograbek A, McCormack T. Expert recommendations on the management of hypertension in patients with ovarian and cervical cancer receiving bevacizumab in the UK. Br J Cancer. 2019;121(2):109–16.CrossRef Plummer C, Michael A, Shaikh G, Stewart M, Buckley L, Miles T, Ograbek A, McCormack T. Expert recommendations on the management of hypertension in patients with ovarian and cervical cancer receiving bevacizumab in the UK. Br J Cancer. 2019;121(2):109–16.CrossRef
14.
go back to reference Edeline J, Boucher E, Rolland Y, Vauleon E, Pracht M, Perrin C, Le Roux C, Raoul JL. Comparison of tumor response by response evaluation criteria in solid tumors (RECIST) and modified RECIST in patients treated with sorafenib for hepatocellular carcinoma. Cancer. 2012;118(1):147–56.CrossRef Edeline J, Boucher E, Rolland Y, Vauleon E, Pracht M, Perrin C, Le Roux C, Raoul JL. Comparison of tumor response by response evaluation criteria in solid tumors (RECIST) and modified RECIST in patients treated with sorafenib for hepatocellular carcinoma. Cancer. 2012;118(1):147–56.CrossRef
15.
go back to reference Basch E, Iasonos A, McDonough T, Barz A, Culkin A, Kris MG, Scher HI, Schrag D. Patient versus clinician symptom reporting using the National Cancer Institute common terminology criteria for adverse events: results of a questionnaire-based study. Lancet Oncol. 2006;7(11):903–9.CrossRef Basch E, Iasonos A, McDonough T, Barz A, Culkin A, Kris MG, Scher HI, Schrag D. Patient versus clinician symptom reporting using the National Cancer Institute common terminology criteria for adverse events: results of a questionnaire-based study. Lancet Oncol. 2006;7(11):903–9.CrossRef
16.
go back to reference Tan G, Jensen MP, Thornby JI, Shanti BF. Validation of the brief pain inventory for chronic nonmalignant pain. J Pain. 2004;5(2):133–7.CrossRef Tan G, Jensen MP, Thornby JI, Shanti BF. Validation of the brief pain inventory for chronic nonmalignant pain. J Pain. 2004;5(2):133–7.CrossRef
17.
go back to reference Eskander RN, Tewari KS. Development of bevacizumab in advanced cervical cancer: pharmacodynamic modeling, survival impact and toxicology. Future Oncol. 2015;11(6):909–22.CrossRef Eskander RN, Tewari KS. Development of bevacizumab in advanced cervical cancer: pharmacodynamic modeling, survival impact and toxicology. Future Oncol. 2015;11(6):909–22.CrossRef
18.
go back to reference Monk BJ, Sill MW, McMeekin DS, Cohn DE, Ramondetta LM, Boardman CH, Benda J, Cella D. Phase III trial of four cisplatin-containing doublet combinations in stage IVB, recurrent, or persistent cervical carcinoma: a gynecologic oncology group study. J Clin Oncol. 2009;27(28):4649–55.CrossRef Monk BJ, Sill MW, McMeekin DS, Cohn DE, Ramondetta LM, Boardman CH, Benda J, Cella D. Phase III trial of four cisplatin-containing doublet combinations in stage IVB, recurrent, or persistent cervical carcinoma: a gynecologic oncology group study. J Clin Oncol. 2009;27(28):4649–55.CrossRef
19.
go back to reference Tewari KS, Sill MW, Monk BJ, Penson RT, Long HJ, Poveda A, Landrum LM, Leitao MM, Brown J, Reid TJA, Michael HE, Moore DH. Prospective validation of pooled prognostic factors in women with advanced cervical Cancer treated with chemotherapy with/without Bevacizumab: NRG oncology/GOG study. Clin Cancer Res. 2015;21(24):5480–7.CrossRef Tewari KS, Sill MW, Monk BJ, Penson RT, Long HJ, Poveda A, Landrum LM, Leitao MM, Brown J, Reid TJA, Michael HE, Moore DH. Prospective validation of pooled prognostic factors in women with advanced cervical Cancer treated with chemotherapy with/without Bevacizumab: NRG oncology/GOG study. Clin Cancer Res. 2015;21(24):5480–7.CrossRef
20.
go back to reference Banerjee S. Bevacizumab in cervical cancer: a step forward for survival. Lancet. 2017;390(10103):1626–8.CrossRef Banerjee S. Bevacizumab in cervical cancer: a step forward for survival. Lancet. 2017;390(10103):1626–8.CrossRef
21.
go back to reference Monk BJ, Sill MW, Burger RA, Gray HJ, Buekers TE, Roman LD. Phase II trial of Bevacizumab in the treatment of persistent or recurrent squamous cell carcinoma of the cervix: a gynecologic oncology group study. J Clin Oncol. 2009;27(7):1069–74.CrossRef Monk BJ, Sill MW, Burger RA, Gray HJ, Buekers TE, Roman LD. Phase II trial of Bevacizumab in the treatment of persistent or recurrent squamous cell carcinoma of the cervix: a gynecologic oncology group study. J Clin Oncol. 2009;27(7):1069–74.CrossRef
22.
go back to reference Marth C, Landoni F, Mahner S, McCormack M, Gonzalez-Martin A, Colombo N, Committee EG. Cervical cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2017;28(suppl_4):iv72–83.CrossRef Marth C, Landoni F, Mahner S, McCormack M, Gonzalez-Martin A, Colombo N, Committee EG. Cervical cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2017;28(suppl_4):iv72–83.CrossRef
23.
go back to reference Lee N, Kim SI, Lee M, Kim HS, Kim JW, Park NH, Song YS. Bevacizumab efficacy and recurrence pattern of persistent and metastatic cervical Cancer. In Vivo. 2019;33(3):863–8.CrossRef Lee N, Kim SI, Lee M, Kim HS, Kim JW, Park NH, Song YS. Bevacizumab efficacy and recurrence pattern of persistent and metastatic cervical Cancer. In Vivo. 2019;33(3):863–8.CrossRef
24.
go back to reference He X, Liu J, Xiao L, Zhao M, Su T, Liu T, Han G, Wang Y. Cisplatin-based chemotherapy with or without bevacizumab for Chinese postmenopausal women with advanced cervical cancer: a retrospective observational study. BMC Cancer. 2020;20(1):381.CrossRef He X, Liu J, Xiao L, Zhao M, Su T, Liu T, Han G, Wang Y. Cisplatin-based chemotherapy with or without bevacizumab for Chinese postmenopausal women with advanced cervical cancer: a retrospective observational study. BMC Cancer. 2020;20(1):381.CrossRef
25.
go back to reference Randall LM, Monk BJ. Bevacizumab toxicities and their management in ovarian cancer. Gynecol Oncol. 2010;117(3):497–504.CrossRef Randall LM, Monk BJ. Bevacizumab toxicities and their management in ovarian cancer. Gynecol Oncol. 2010;117(3):497–504.CrossRef
26.
go back to reference Brandes AA, Bartolotti M, Tosoni A, Poggi R, Franceschi E. Practical management of bevacizumab-related toxicities in glioblastoma. Oncologist. 2015;20(2):166–75.CrossRef Brandes AA, Bartolotti M, Tosoni A, Poggi R, Franceschi E. Practical management of bevacizumab-related toxicities in glioblastoma. Oncologist. 2015;20(2):166–75.CrossRef
27.
go back to reference Apte RS, Chen DS, Ferrara N. VEGF in signaling and disease: beyond discovery and development. Cell. 2019;176(6):1248–64.CrossRef Apte RS, Chen DS, Ferrara N. VEGF in signaling and disease: beyond discovery and development. Cell. 2019;176(6):1248–64.CrossRef
28.
go back to reference Minion LE, Tewari KS. The safety and efficacy of bevacizumab in the treatment of patients with recurrent or metastatic cervical cancer. Expert Rev Anticancer Ther. 2017;17(3):191–8.CrossRef Minion LE, Tewari KS. The safety and efficacy of bevacizumab in the treatment of patients with recurrent or metastatic cervical cancer. Expert Rev Anticancer Ther. 2017;17(3):191–8.CrossRef
29.
go back to reference Neagoe PE, Lemieux C, Sirois MG. Vascular endothelial growth factor (VEGF)-A165-induced prostacyclin synthesis requires the activation of VEGF receptor-1 and -2 heterodimer. J Biol Chem. 2005;280(11):9904–12.CrossRef Neagoe PE, Lemieux C, Sirois MG. Vascular endothelial growth factor (VEGF)-A165-induced prostacyclin synthesis requires the activation of VEGF receptor-1 and -2 heterodimer. J Biol Chem. 2005;280(11):9904–12.CrossRef
30.
go back to reference Carpini JD, Karam AK, Montgomery L. Vascular endothelial growth factor and its relationship to the prognosis and treatment of breast, ovarian, and cervical cancer. Angiogenesis. 2010;13(1):43–58.CrossRef Carpini JD, Karam AK, Montgomery L. Vascular endothelial growth factor and its relationship to the prognosis and treatment of breast, ovarian, and cervical cancer. Angiogenesis. 2010;13(1):43–58.CrossRef
Metadata
Title
Cisplatin plus paclitaxel chemotherapy with or without bevacizumab in postmenopausal women with previously untreated advanced cervical cancer: a retrospective study
Authors
Guanghua Chu
Xiangzhen Liu
Weiguang Yu
Meiji Chen
Lingyun Dong
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2021
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-021-07869-7

Other articles of this Issue 1/2021

BMC Cancer 1/2021 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine