Abstract
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.
Key words
bevacizumab - VEGF antibody - cervical cancer - neoadjuvant chemotherapy
