PCN38 A Literature Review Of Recurrent Or Metastatic Cervical Cancer Disease Burden, Treatment Outcomes, And Unmet Needs

Abstract

We analyzed publicly available data on disease burden, clinical outcomes with novel therapies, and unmet needs for recurrent or metastatic (Rec/Met) cervical cancer (CC) patients. A targeted literature review was conducted in MEDLINE/Embase (January 2010-April 2020) of studies on Rec/Met CC burden and clinical outcomes with therapies including bevacizumab combination therapy (BEVA), pembrolizumab, and topotecan in randomized controlled trials and observational studies. A total of 41 publications, including 32 unique clinical outcomes studies, were descriptively summarized. The global incidence and mortality rates for CC were 13.1/100,000 and 6.9/100,000 women in 2018, respectively. Metastatic CC patients’ mortality was 3 times higher than nonmetastatic CC (58.7% vs 18.5%; years 2005-2010). Sample size was small in most clinical outcomes studies; 63% of the 32 studies had <30 patients. Among all 32 studies, median progression-free survival (mPFS) ranged from 2.0 (pembrolizumab) to 13.1 (BEVA) months and median overall survival (mOS) ranged from 6.4 (topotecan) to 26.0 (BEVA) months. Only 31% (10/32) of the studies reported clinical outcomes by treatment line. In the first-line setting, mPFS ranged from 6.3-12.0 months, mOS ranged from 13.2-21.5 months, and objective response rate (ORR) ranged from 35%-59% with BEVA; mPFS was 7.1 months, mOS was 13.2 months, and ORR was 35% with topotecan. In studies of second or later lines of therapy, mPFS was 4.1 months and mOS was 5.2 months with BEVA; mPFS was 2.0 months, mOS was 11.0 months, and ORR was 11% (17% in PD-L1–positive patients) with pembrolizumab; mPFS was 2.5 months, mOS was 6.4 and 7.3 months, and ORR was 0% with topotecan. Clinical treatment outcomes, including OS, PFS, and ORR, among Rec/Met CC patients are poor and become progressively worse in second and later lines. Innovative treatments are needed to address the unmet needs for Rec/Met CC patients.