Experiences with off-lable use of bevacizumab in patients with first-diagnosed locally advanced and metastatic cervical cancer

Introduction: Invasive cervical cancer is the fourth most cancer of women in western civilization. Complete recurrence rates after neoadjuvant therapy in bulky disease remain poor and new strategies are needed. Here, we present our clinical experiences with platinum- and taxane based cytotoxic therapy in combination with bevacizumab in patients with cervical cancer.

Methods: All patients from 2008 – 2015 with locally advanced and metastatic cervical cancer who have been treated with radiochemotherapy or platinumbased chemotherapy in combination with or without bevacizumab were included in this retrospective study.

Results: We identified 32 patients, who have been treated with neoadjuvant chemotherapy or radiochemotherapy. 23 patients received cisplatin and docetaxel, four of these patients underwent a combined radiochemotherapy in FIGO stage III and IV. Four patients received platinum-based chemotherapy in combination with bevacizumab, whereas one patient had FIGO stage IIb and two patients had FIGO stage IVa. The fourth patient had a FIGO stage IVb cervical cancer due to liver metastasis. Complete pathologic recurrence could be achieved in patients with FIGO stage I or II cervical cancer. In FIGO stage III and IV no complete pathologic recurrence was noted. In combination with bevacizumab two complete pathologic recurrences, one complete clinical recurrence and one partial pathologic recurrence was observed.

Conclusion: Our results show that a complete pathologic recurrence with conventional neoadjuvant chemotherapy is possible in early stage (FIGO I) cervical cancer. Moreover, patients with advanced and/or metastatic cervical cancer can benefit from bevacizumab in combination with conventional neoadjuvant chemotherapy.