Gynecologic Medical Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Body Imaging Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Gynecol Oncol. 2021 Jun;161(3):720-726. doi: 10.1016/j.ygyno.2021.04.016. Epub 2021 Apr 22.
Prospective data have demonstrated the efficacy of bevacizumab monotherapy in the treatment of advanced endometrial cancer. Bevacizumab is used off-label, and real-world data regarding the role of bevacizumab in endometrial cancer treatment are scant. In this largest single-institution retrospective study of its kind, we report our experience with bevacizumab monotherapy in the treatment of advanced/recurrent endometrial cancer.
All eligible patients (n = 101) had histologically confirmed endometrial cancer and were treated with bevacizumab at our institution from 2004 to 2017. Demographic data and tumor characteristics were obtained through chart review. Primary objective was response to therapy determined by Response Evaluation Criteria in Solid Tumors (RECIST v1.1).
Analysis included 13 grade 1/2 endometrioid, 15 grade 3 endometrioid, 44 serous, 8 carcinosarcoma, and 21 other/mixed histologies. No patients achieved complete (CR) or partial (PR) responses; 19 achieved stable disease (SD). The clinical benefit rate (CBR; CR + PR + SD) was 19% (95% CI: 12-28%). The CBRs were 7%, 17%, 21%, and 23% for patients with 1, 2, 3, and ≥ 4 prior treatment lines. Median PFS ranged from 2.6 months (2 lines) to 4.9 months (≥4 lines). The 3-year OS rate was 58% (95% CI: 47-67%). The median OS was 3.4 years (95% CI: 2.9-4.2), ranging from 2.5 years (2 lines) to 4.5 years (≥4 lines). The most common treatment-related adverse event was hypertension; 35 (78%) of 45 were grade 1 or 2.
In heavily pretreated advanced endometrial cancer, bevacizumab was associated with modest clinical efficacy and remains a viable palliative option in this setting.
前瞻性数据已经证明贝伐单抗单药治疗晚期子宫内膜癌的疗效。贝伐单抗是一种超适应证使用的药物，关于其在子宫内膜癌治疗中的作用的真实世界数据很少。在这项同类最大的单机构回顾性研究中，我们报告了我们在治疗晚期/复发性子宫内膜癌中使用贝伐单抗单药治疗的经验。
所有符合条件的患者（n=101）均经组织学证实患有子宫内膜癌，并于 2004 年至 2017 年在我们的机构接受贝伐单抗治疗。通过病历回顾获得人口统计学数据和肿瘤特征。主要目标是通过实体瘤反应评价标准（RECIST v1.1）确定治疗反应。
分析包括 13 例 1/2 级子宫内膜样癌、15 例 3 级子宫内膜样癌、44 例浆液性癌、8 例癌肉瘤和 21 例其他/混合组织学类型。没有患者达到完全缓解（CR）或部分缓解（PR）；19 例患者疾病稳定（SD）。临床获益率（CBR；CR+PR+SD）为 19%（95%CI：12-28%）。在接受 1、2、3 和≥4 线治疗的患者中，CBR 分别为 7%、17%、21%和 23%。中位 PFS 范围为 2.6 个月（2 线）至 4.9 个月（≥4 线）。3 年 OS 率为 58%（95%CI：47-67%）。中位 OS 为 3.4 年（95%CI：2.9-4.2），范围为 2.5 年（2 线）至 4.5 年（≥4 线）。最常见的治疗相关不良事件是高血压；45 例中有 35 例（78%）为 1 级或 2 级。
在经过大量预处理的晚期子宫内膜癌中，贝伐单抗具有适度的临床疗效，在这种情况下仍然是一种可行的姑息治疗选择。
