Adding bevacizumab (Avastin®) to chemotherapy in patients with advanced cervical cancer prolongs survival, according to a study just published in the New England Journal of Medicine.1
The study recruited 452 women in the United States and Spain and assigned them to one of four treatment groups: cisplatin plus paclitaxel with or without bevacizumab, or topotecan plus paclitaxel with or without bevacizumab. Each regimen was administered at 21-day intervals until the onset of disease progression, unacceptable adverse effects, or a complete response.
All patients had recurrent, persistent, or metastatic disease. Patients who were candidates for curative surgical treatment were excluded from the study.
Better Response and Better Survival
After median follow-up of 20.8 months, 271 patients (60%) had died. Median overall survival was 17 months in patients treated with bevacizumab plus chemotherapy and 13.3 months in patients treated with chemotherapy alone (hazard ratio [HR] for death, 0.71; 95% CI, 0.54-0.95).
Median progression-free survival was also longer in bevacizumab-treated patients: 8.2 versus 5.9 months (HR 0.67; 95% CI, 0.54-0.82).
The response rate was 48% in patients who received bevacizumab and 36% in patients who did not. A complete response was achieved by 28 patients treated with chemotherapy plus bevacizumab and 14 patients treated with chemotherapy alone.
In the cisplatin plus paclitaxel arm, response rates were similar between patients who received bevacizumab and those who did not (50% vs 45%; P = 0.51), but bevacizumab-treated patients had a 32% lower risk of death (HR 0.68; 95% CI, 0.48-0.97).
By contrast, in the topotecan plus paclitaxel arm, the response rate was higher in patients who received bevacizumab than in those who did not (47% vs 27%; P = 0.002), but the survival rate was not significantly better (HR for death, 0.74; 95% CI, 0.53-1.05).