Cervical cancer is the second most frequent cancer among women in Uzbekistan. Due to poor accessibility of radiation therapy, especially in remote regions, addition of bevacizumab to platinum containing chemotherapy leads to improvement in overall survival in advanced cervical cancer. We therefore studied addition of bevacizumab to chemotherapy in a group of cervical cancer patients
The prospective study enrolled 54 patients with cervical cancer FIGO IIB stage, who underwent neoadjuvant chemotherapy: paclitaxel 175mg/m2 + carboplatin AUC6 + bevacizumab 15 mg/kg every 21 days. The control arm included 55 patients with the same stage cervical cancer, who underwent platinum containing chemotherapy in the same dosage, but without bevacizumab. The response rates were determined by means of preoperative clinical examination, diagnostic imaging (RECIST), changes in tumour markers (SCC) and by histopathology
Clinical response rate after addition of bevacizumab was found in 88,8% of patients, and 74,5 % of patients who were treated without bevacizumab (p = 0.025), Addition of bevacizumab to platinum containing therapy led to higher rate of clinical complete remission (44.9 vs. 15.5%; p = 0.072). Significant reduction of tumor size was observed in all patients 100% who were treated chemotherapy + bevacizumab, and in 75% cases in patients only chemotherapy, this fact led to higher operability rates in both. The rate of pathological complete response(pCR) was altered significantly 28.6% bevacizumab free therapy vs. 44.5% chemotherapy + bevacizumab (p ≤ 0.005)
Addition of bevacizumab led to avoiding radiation therapy, better clinical response, higher operability and PCR rates. Further validation of angiogenesis Inhibitors in neoadjuvant treatment of cervical cancer needs larger multicentric randomized clinical trials