EP067/#802 A comparison of adverse outcomes with the use of bevacizumab with cisplatin/paclitaxel or carboplatin/paclitaxel in recurrent, persistent or metastatic cervical cancer. (4th December 2022) - Kotait, Maryam
Abstract : Objectives: Background: GOG-240 demonstrated improved oncologic outcomes with addition of bevacizumab to standard chemotherapy for metastatic or recurrent cervical carcinoma. Previously, JCOG0505 revealed non-inferior oncologic outcomes of carboplatin/paclitaxel(TC) compared to cisplatin/paclitaxel(TP). However, there is no recent data comparing adverse events and chemotherapy response rates between TC and TP since addition of bevacizumab. Objective: To compare adverse events and response to chemotherapy of patients with metastatic or recurrent non-resectable cervical carcinoma who initiated chemotherapy between 01/2015 and 09/2021 with carboplatin/paclitaxel/bevacizumab(TCB) or cisplatin/paclitaxel/bevacizumab(TPB). Methods: A retrospective study was conducted. Adverse events were classified using the National Cancer Institute Common Terminology Criteria for Adverse Events. Results: Forty-seven patients were included; 29 with squamous cell histology and 18 with adenocarcinoma or adenosquamous histology. Median follow-up was 19 months. Thirty-eight patients received TCB, 9 received TPB; 19 were treated for metastatic disease, 3 for persistent disease, and 26 for recurrent disease. Median number of chemotherapy cycles was 6. While response to chemotherapy was similar in both groups (stable disease 13.2% vs 33.3%, p=0.15, partial or complete response, 36.8% vs 33.3%, p=0.84), patients receiving TCB experienced significantly less grade 3–5 (26.3% vs 66.7%, p=0.02) and grade 1–2 adverse events (13.2% vs 55.6%, p=0.005). Bevaziumab was discontinued in 12 patients (25.5%) due to severe toxicity, with significantly greater rate of fistula and perforation compared to rates in GOG 240 (12.8% vs 3%, p=0.004). Conclusions: In this cohort, patients receiving TCB had similar response to chemotherapy, but significantly less adverse events, than those receiving TPB. Bevacizumab confers a high risk of severe adverse events.