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. 2022 May 28:42:101013.
doi: 10.1016/j.gore.2022.101013. eCollection 2022 Aug.

Metronomic chemotherapy using oral cyclophosphamide and bevacizumab for recurrent cervical cancer: A multi-institutional retrospective study

Roze Isono-Taniguchi  1 , Mayako Goto  2 , Yumi Takimoto  1 , Tomoko Ueda  1 , Yu Wakimoto  1 , Kayo Inoue  1 , Kensuke Hori  2 , Kimihiko Ito  2 , Hiroshi Tsubamoto  1
Affiliations

Metronomic chemotherapy using oral cyclophosphamide and bevacizumab for recurrent cervical cancer: A multi-institutional retrospective study

Roze Isono-Taniguchi et al. Gynecol Oncol Rep. .

Abstract

No standard chemotherapy is available after disease progression or anaphylaxis during platinum chemotherapy among patients with recurrent cervical cancer. Here we report the efficacy and toxicities of metronomic chemotherapy consisting of 50 mg of oral cyclophosphamide (CPA) daily and intravenous 15 mg/kg of bevacizumab (BEV) repeated every 3 weeks (CPA-BEV). Treated patients were retrospectively reviewed. Adverse events and response rates were recorded according to the Common Toxicity Criteria for Adverse Events (CTCAE) ver 5.0 and Response Evaluation Criteria In Solid Tumors ver 1.1, respectively. Eleven patients had been treated with CPA-BEV between 2016 and 2021.The pathologic types were squamous cell carcinoma in seven patients, adenocarcinoma in three, and large cell neuroendocrine carcinoma in one. Nine patients had primary concurrent chemoradiotherapy (CCRT). Five patients received more than one prior chemotherapy (excluding CCRT). Six patients had progressive disease during prior platinum-based chemotherapy, four patients recurred within 6 months of the last platinum administration, and one patient had platinum anaphylaxis. Grade 3 or more hematologic toxicities and grade 2 or more non-hematological toxicities were observed in one with grade 3 neutropenia and in one with grade 2 proteinuria, respectively. The median duration of chemotherapy was 2.8 months (range 0.2-30.6 months). One patient had CR but none had PR. Median progression-free survival was 2.8 months (95 %CI: 2.1-10.7 months), and median overall survival was 13.6 months (95 %CI: 8.4-33.7 months). In conclusion, the CPA-BEV regimen showed favorable antitumor activity with minimal toxicity and is promising candidate for second-line chemotherapy.

Keywords: Bevacizumab; Cervical cancer; Cyclophosphamide; Metronomic chemotherapy.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Prognosis after CPA-BEV treatment. The median progression-free survival (PFS) and overall survival (OS) after the administration of oral cyclophosphamide and bevacizumab for the patients with recurrent cervical cancer. Median PFS was 2.8 months (95% CI: 2.1–10.7 months) and median OS was 13.6 months (95% CI: 8.4–33.7 months). The PFS rate at 6 months were 27% (95% CI: 1.0–54%) and the OS rate at 18 months was 36% (95% CI: 7.9–64.8%).
See this image and copyright information in PMC

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