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.