Avastin increases cervical cancer survival

Avastin (bevacizumab) increases cervical cancer survival for women by almost four months, according to a recent report.

Median overall survival was 17 months with bevacizumab, versus 13.3 months with chemotherapy alone. The addition of bevacizumab led to a higher response rate but also was associated with more toxicity.

"There has been a large unmet medical need for active treatments for cervical cancer, which is a leading cause of death from cancer in developing countries," said Dr. Krishnansu Tewari of the University of California Irvine in a statement.

A randomized trial was used involving 452 patients with recurrent, persistent or metastatic cervical cancer. Patients were evaluated based on chemotherapy alone - consisting of cisplatin and paclitaxel or topotecan and paclitaxel - or with bevacizumab.

With the addition of bevacizumab the survival rate was 0.71 (P=0.004), and response rates were 48 percent with bevacizumab and 36 percent with chemotherapy alone (P=0.008).

In most cases, curative options for those with early-stage and locally advanced cervical cancer are surgery, platinum-based chemoradiation or a combination of both. But for women with heavily pretreated cervical cancer, bevacizumab represents a suitable treatment option. The study is the first to demonstrate a survival benefit in cervical cancer treated with a targeted agent, said Dr. Carol Aghajanian of Memorial Sloan-Kettering Cancer Center in New York City.

Bevacizumab-containing therapy is also associated with toxicity. The results showed grade 2+ hypertension in 29 percent of patients versus 2 percent in those who only received chemotherapy. Grade 3+ thromboembolic events occurred in 8 percent of bevacizumab-treated patients and 1 percent of patients who received chemotherapy. Grade 3+ gastrointestinal fistula occurred in 3 percent of the bevacizumab-treated patients and none of the patients who had chemotherapy without bevacizumab.

Bevacizumab aside, the routine screenings and vaccination for human papillomavirus (HPV) are still important, according to is Roswell Park Cancer Institute's Dr. Peter Frederick, who agrees that early detection is key to cervical cancer prevention.

"Patients who are at risk for recurrent disease are those patients who are diagnosed at a more advanced stage initially," he said. "For example, patients with a stage IA disease have a 5-year survival of over 90 percent. These patients are at low risk for recurrence. In contrast, the 5-year survival for patients with stage III disease drops to about 30 percent to 40 percent, which underscores how important it is to diagnose this cancer early."