Department of Obstetrics and Gynecology, University Hospital Cologne and Medical Faculty, Cologne, Germany;
Institute for Pathology, University Hospital Cologne and Medical Faculty, Cologne, Germany.
In Vivo. 2024 Nov-Dec;38(6):3068-3077. doi: 10.21873/invivo.13791.
BACKGROUND/AIM: We hypothesized that adding bevacizumab to platinum-based neoadjuvant chemotherapy - whose efficacy for patients with recurrent or metastatic cervical cancer has already been proven - could optimize the therapy regimen, leading to improved response rates and survival outcomes.
Forty patients with histologically confirmed cervical cancer with FIGO stage IB3-IVA who received platinum-based neoadjuvant treatment between March 2008 and January 2019 in the Department of Obstetrics and Gynecology of University Hospital Cologne were analyzed. Twenty patients were treated with additional bevacizumab. The comparative cohort consisted of 18 patients treated with neoadjuvant chemotherapy alone. The response rates and clinical outcomes, including progression-free survival and overall survival, were evaluated.
Neoadjuvant chemotherapy combined with bevacizumab significantly improved the response rate (p=0.046). The survival analysis showed that patients treated without bevacizumab had better progression-free survival up to FIGO stage IVA than patients treated with bevacizumab. However, overall survival was similar for both cohorts. For patients with advanced tumor stage, including FIGO IVB, progression-free survival and overall survival improved with the addition of bevacizumab. Pathological complete remission was a statistically significant prognostic factor for progression-free survival (p=0.039) but did not significantly affect overall survival (p=0.098).
While bevacizumab did not demonstrate a significant improvement in overall survival rates, it was associated with a notable reduction in tumor size and showed a trend towards improved clinical response rates. These findings suggest that bevacizumab may have potential in optimizing the neoadjuvant treatment approach.
背景/目的：我们假设在已经证实对复发性或转移性宫颈癌患者有效的铂类新辅助化疗基础上加入贝伐珠单抗，可以优化治疗方案，提高缓解率和生存结果。
分析了 2008 年 3 月至 2019 年 1 月期间在科隆大学医院妇产科接受铂类新辅助治疗的 40 例经组织学证实的宫颈癌 FIGO 分期 IB3-IVA 患者。其中 20 例患者接受了贝伐珠单抗的辅助治疗。对比队列包括 18 例仅接受新辅助化疗的患者。评估了缓解率和临床结果，包括无进展生存期和总生存期。
新辅助化疗联合贝伐珠单抗显著提高了缓解率（p=0.046）。生存分析表明，未接受贝伐珠单抗治疗的患者在 FIGO 分期 IVA 之前无进展生存期优于接受贝伐珠单抗治疗的患者。然而，两组的总生存期相似。对于包括 FIGO IVB 在内的晚期肿瘤患者，加入贝伐珠单抗可改善无进展生存期和总生存期。病理完全缓解是无进展生存期的统计学显著预后因素（p=0.039），但对总生存期无显著影响（p=0.098）。
尽管贝伐珠单抗并未显著提高总生存率，但与肿瘤体积的显著缩小相关，并显示出改善临床缓解率的趋势。这些发现表明，贝伐珠单抗可能具有优化新辅助治疗方法的潜力。
