354 Bevacizumab with metronomic oral cyclophosphamide for patients with recurrent cervical cancer. (13th November 2020) - Isono, R
Abstract : No standard treatment is available for 2nd line, especially for patients who experience anaphylaxis to platinum, or develop early recurrence. Previously, we reported 4 cases treated with 50 mg of oral cyclophosphamide daily and 15 mg/kg of intravenous bevacizumab every 3 weeks (mCPA-BEV). Here, we report follow up of the 4 cases and the additional cases. Methods: Patients with cervical cancer who had anaphylaxis to platinum or who recurred less than 6 months after the last administration of cisplatin, and treated with mCPA-BEV were retrospectively reviewed. Adverse events and response rate were recorded according to CTCAE ver 5.0 and RECIST ver 1.1, respectively. Results: During 2016 and 2020, 11 patients were enrolled. Histology of the tumor were SCC in 6, adeno in 3, adeno-SCC in 1, and LCNEC in 1. Two patients had platinum anaphylaxis, 7 patients had progressive disease during previous chemotherapy, and 2 patients recurred within 6 months. One patient suffered from grade 3 neutropenia; however, no grade 2 or higher non-hematological toxicities were observed. Median duration of chemotherapy was 4.1M (range 0.2–30.6 M). One patient had CR in RECIST criteria, and none had PR. Median PFS was 4.1 months (95%CI: 2.1–11.3M), and median OS was 33.7M (95%CI: 13.5–33.7M, figure 1 ). Conclusion: The tumor dormancy was probably maintained by long administration with mild toxicities. These cases demonstrate the use of mCPA-BEV with minimal toxicity and expected anti-cancer activity and indicate that this regimen could be considered for the second-line chemotherapy in advanced recurrent cervical cancer.