Neoadjuvant Therapy of Cervical Carcinoma with the Angiogenesis Inhibitor Bevacizumab: a Single-Centre Analysis
| Autor: | J Puppe, Martin Hellmich, Christian Domröse, Fabinshy Thangarajah, Bernd Morgenstern, M Wirtz, Philip Junker, Angela Cepic, Peter Mallmann, Dominik Ratiu |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
0301 basic medicine
Oncology medicine.medical_specialty Bevacizumab cervical cancer medicine.medical_treatment 03 medical and health sciences 0302 clinical medicine Internal medicine Maternity and Midwifery medicine GebFra Science Prospective cohort study Neoadjuvant therapy Cervical cancer neoadjuvante Chemotherapie Chemotherapy business.industry Obstetrics and Gynecology Cancer Original Article/Originalarbeit Zervixkarzinom Retrospective cohort study VEGF-Antikörper medicine.disease Angiogenesis inhibitor neoadjuvant chemotherapy VEGF antibody 030104 developmental biology 030220 oncology & carcinogenesis business medicine.drug |
| Zdroj: | Geburtshilfe und Frauenheilkunde |
| ISSN: | 1438-8804 0016-5751 |
| DOI: | 10.1055/a-0641-5588 |
| Popis: | Introduction Cervical cancer is the fourth most frequent cancer in women worldwide. Addition of the VEGF antibody bevacizumab in combination with platinum-containing chemotherapy achieved an improvement in overall survival in advanced cervical cancer. To date there are no data on neoadjuvant use of bevacizumab. We therefore studied the benefit of neoadjuvant combined therapy with bevacizumab in a group of cervical cancer patients. Patients and Methods This retrospective cohort study analysed 14 patients with cervical cancer FIGO stages 1b1 to IV who received neoadjuvant platinum-containing chemotherapy in combination with bevacizumab. The comparative cohort consisted of 16 patients who were treated with neoadjuvant platinum-containing chemotherapy alone. The response rates were determined by means of preoperative clinical examination, diagnostic imaging (RECIST), changes in tumour markers (SCC) and by histopathology. Results A clinical response was found in 93.8% (n = 15) of patients after bevacizumab-free therapy and in 100% (n = 14) of the patients who were treated with bevacizumab in addition. Combined therapy with bevacizumab led to a higher rate of clinical complete remission (42.9 vs. 12.5%; p = 0.072) and significantly improved the reduction in tumour size (Δ longest diameter: 3.7 vs. 2.5 cm; p = 0.025). Downgrading was observed in 100% of all patients treated with bevacizumab compared with 75% in the control arm. The rate of pathological complete remission (pCR) was not altered significantly (28.6% [n = 4] vs. 37.5% [n = 6]; p = 0.460). Discussion Overall, combined therapy with bevacizumab led to a better clinical response. Operability was therefore improved more often. Because of the small patient cohort, larger prospective studies are necessary to validate the effect of neoadjuvant combined therapy with bevacizumab. |
| Databáze: | OpenAIRE |
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