Adding bevacizumab to combination chemotherapy improved survival for women with advanced cervical cancer.
Women in the Gynecologic Oncology Group (GOG) trial who received bevacizumab in addition to chemotherapy lived about 4 months longer than their counterparts who received chemotherapy alone, Dr. Krishnansu S. Tewari and his associates reported Feb. 20 in the New England Journal of Medicine.
The trial was open to women who had chemotherapy-naive, recurrent, persistent, or metastatic cervical cancer. A total of 452 women were randomized in dual factorial design according to chemotherapy doublet (cisplatin plus paclitaxel vs. topotecan plus paclitaxel) and receipt of bevacizumab (yes vs. no). Treatment was on an open-label basis, and crossover was not allowed (N. Engl. J. Med. 2014;370:734-43).
Dr. Krishnansu S. Tewari
An interim analysis showed that the topotecan-paclitaxel regimen was neither superior nor inferior to the cisplatin-paclitaxel regimen that has been the standard in this setting.
With longer follow-up, to a median of 20.8 months, women who received added bevacizumab had a longer median overall survival than did their counterparts who received chemotherapy alone (17.0 vs. 13.3 months; hazard ratio, 0.71; P = .0035). Bevacizumab conferred a significant survival benefit when added to cisplatin-paclitaxel chemotherapy (HR, 0.68; P = .03) but not when added to topotecan-paclitaxel chemotherapy (HR, 0.74; P = .09).
Adverse effects were largely consistent with previous experience in other cancers with bevacizumab, a vascular endothelial growth factor (VEGF) inhibitor, Dr. Tewari and his associates reported.
The study was presented last year at the annual meeting of the American Society of Clinical Oncology. See our full coverage here.
The trial was sponsored by the National Cancer Institute. Dr. Tewari disclosed no relevant conflicts of interest. Roche/Genentech provided bevacizumab for the trial.