The real-world efficacy and toxicity of first-line paclitaxel and cisplatin with bevacizumab in platinum-naïve primary stage IVB cervical cancer

Abstract

Objective: To investigate the real-world efficacy and toxicity of paclitaxel-cisplatin-bevacizumab and identify prognostic factors for paclitaxel-cisplatin-bevacizumab in platinum-naïve primary stage IVB cervical cancer.

Materials and methods: We retrospectively reviewed patients with stage IVB cervical cancer who received paclitaxel-cisplatin-bevacizumab as first-line treatment between July 2015 and December 2021 at Asan Medical Center, Korea. Patient data including clinicopathologic characteristics, imaging, paclitaxel-cisplatin-bevacizumab administration, recurrence, and survival were collected.

Results: Overall, 61 patients were included in this study. The median age of the patients was 56 (range, 28-79) years. Patients received a median of 9 (range, 2-30) cycles of paclitaxel-cisplatin-bevacizumab. The most common adverse event (all grades) during treatment was azotemia (80.3 %). Dose reduction and drug interruption were conducted in 41.0 % and 26.2 % of patients, respectively. The median progression-free survival (PFS) and the median overall survival (OS) were 11.8 (95 % confidence interval [CI], 9.3-14.2) and 24.3 (95 % CI, 16.9-31.7) months, respectively. Multivariate analysis indicated that cervical mass size reduction rate ≥40 % at the longest diameter was an independent prognostic factor for PFS (adjusted hazard ratio, 0.24; 95 % CI, 0.11-0.53; p < 0.001). The median PFS of the patients with cervical mass size reduction rate ≥40 % and <40 % were 13.7 (95 % CI, 10.9-16.5) and 5.9 (95 % CI, 0-12.6) months, respectively (p < 0.001).

Conclusion: Paclitaxel-cisplatin-bevacizumab is effective and tolerable as a first-line treatment for platinum-naïve primary stage IVB cervical cancer. Cervical mass size reduction rate ≥40 % during paclitaxel-cisplatin-bevacizumab treatment might be a potential prognostic factor for PFS in patients with platinum-naïve primary stage IVB cervical cancer.

Keywords: Bevacizumab; Cervical cancer; Cisplatin; Paclitaxel; Prognostic factor; Survival.