Abstract
BackgroundThe purpose of this study was to assess the efficacy and safety of cisplatin-based chemotherapy with or without bevacizumab (BEV) in Chinese women with advanced cervical cancer (ACC).MethodsFor this observational study, we analysed the data of 316 Chinese women with ACC who were treated at the Henan provincial people’s hospital between Jan 1, 2014, and Dec 31, 2018, with cisplatin-based chemotherapy plus BEV (CB) or cisplatin-based chemotherapy alone (CA) until disease progression, unacceptable toxicity, or death. The co-primary endpoints were overall survival (OS) and progression-free survival (PFS); the secondary endpoint was the occurrence of adverse events (AEs).ResultsA total of 264 patients with ACC were included in the assessment (CB, n = 130 and CA, n = 134). At a median follow-up of 38 months (IQR 36–40), the median OS in the CB cohort was significantly longer than that in the CA cohort (hazard ratio [HR] 1.21, 95% confidence interval[CI] 1.14–1.73; p = 0.002); additionally, the median PFS was 345 days (95% CI, 318–372) for CB and 261 days (95% CI, 165–357) for CA(HR 1.61, 95% CI 1.12–2.17; p = 0.000). Significant differences were noted between groups in terms of thrombosis/embolism, neutropenia, and febrile neutropenia.ConclusionsIn Chinese women with ACC, cisplatin-based chemotherapy plus BEV is associated with improved survival compared to cisplatin-based chemotherapy alone. This finding suggests a positive survival benefit of anti-angiogenesis therapy in this population.
Highlights
The purpose of this study was to assess the efficacy and safety of cisplatin-based chemotherapy with or without bevacizumab (BEV) in Chinese women with advanced cervical cancer (ACC)
Findings from the Gynecologic Oncology Group (GOG)-240 randomized phase III trial [18] indicated that the incorporation of bevacizumab (BEV) with chemotherapy for recurrent, persistent or metastatic cervical cancer markedly increased the survival benefit
A recent phase III trial [19] using a 2 × 2 factorial design that was conducted to verify whether chemotherapy with or without BEV improves overall survival (OS) in women with ACC showed proof-of-concept of the efficacy and tolerability of anti-angiogenesis therapy in ACC because the sustained benefit conferred by chemotherapy plus BEV was evidenced by separated survival curves
Summary
The purpose of this study was to assess the efficacy and safety of cisplatin-based chemotherapy with or without bevacizumab (BEV) in Chinese women with advanced cervical cancer (ACC). Advanced cervical cancer (ACC) is usually regarded as a devastating disease affecting women worldwide because of its association with increased morbidity and mortality [1,2,3,4,5,6]. Several studies [11, 18, 21] have tried to assess whether BEV is independently associated with survival Such studies have had small sample sizes, have included patients undergoing drug treatment without the stratification of outcomes, or failed to adjust for some approved confounders. Data regarding Chinese women with ACC who were treated with BEV-containing chemotherapy are extremely limited
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