Phase II trial of paclitaxel, carboplatin, and bevacizumab for advanced or recurrent cervical cancer

Pharmacological Treatment of Patients with Metastatic, Recurrent or Persistent Cervical Cancer Not Amenable by Surgery or Radiotherapy: State of Art and Perspectives of Clinical Research

“…According to a systematic review of 23 studies, CDDP + PTX + BEV and topotecan + PTX + BEV were likely to prolong OS compared with non-BEV-containing therapies, and CDDP + PTX + BEV had the highest probability of being the most efficacious regimen [112]. Response rates and fistula rates with CBDCA + PTX + BEV are similar to those reported with CDDP + PTX + BEV [114,115]. The risks and benefits of the addition of BEV to chemotherapy should be exhaustively discussed with the patient herself, taking into account the increased probability of fistula formation, especially in the case of locally persistent or recurrent disease after radiotherapy or CCRT [116][117][118].…”

Neoadjuvant chemotherapy with paclitaxel/carboplatin/bevacizumab in advanced vulvar cancer: Time to rethink standard of care?

“…Multiple studies have examined the addition of bevacizumab, a monoclonal antibody directed against vascular endothelial growth factor (VEGF), in treatment regimens in gynecological cancers and confirmed improved outcomes in women with cervical cancer ( Tewari, 2017 , Suzuki, 2019 ). The molecular basis for treatment with bevacizumab in vulvar cancer is supported by the fact that angiogenesis and VEGF have previously been found to play an important role in the progression of vulvar carcinoma ( MacLean et al, 2000 ) and multiple studies have demonstrated good response with the addition of bevacizumab to traditional chemotherapy in the treatment of cervical cancer ( Tewari, 2017 , Suzuki, 2019 ). For example, GOG 240, a recent randomized phase III trial, demonstrated improved overall survival rates in patients with advanced or recurrent cervical cancer who were treated with combination chemotherapy (cisplatin and paclitaxel or topotecan and paclitaxel) with bevacizumab compared to those treated with chemotherapy alone ( Tewari et al, 2017 ).…”

“…For example, GOG 240, a recent randomized phase III trial, demonstrated improved overall survival rates in patients with advanced or recurrent cervical cancer who were treated with combination chemotherapy (cisplatin and paclitaxel or topotecan and paclitaxel) with bevacizumab compared to those treated with chemotherapy alone ( Tewari et al, 2017 ). Additionally, a recent phase II trial showed a median overall survival rate of 88% with treatment with paclitaxel/carboplatin/bevacizumab in patients with advanced or recurrent cervical cancer (50% achieved complete response and 38% achieved partial response) ( Suzuki et al, 2019 ). Our case report and the biologic plausibility for extrapolating cervical cancer treatment to vulvar cancer lends support to potential use of bevacizumab in advanced vulvar cancers.…”

“…Current National Comprehensive Cancer Network (NCCN) treatment recommendations for locally advanced vulvar cancer are chemoradiation with or without groin node dissection ( National Comprehensive Cancer Network, 2020 ). More recent studies have examined the addition of bevacizumab, a monoclonal antibody directed against vascular endothelial growth factor (VEGF), as adjunctive therapy in many gyencological cancers; although this has mainly been studied in patients with cervical cancer ( Tewari, 2017 , Suzuki, 2019 ). The objective of the current case report was to describe the recent successful treatment of two advanced vulvar cancer patients with neoadjuvant chemotherapy with paclitaxel/carboplatin/bevacizumab and to review the current clinical recommendations for treatment of locally advanced vulvar cancer as well as the rationale for potential adoption of neoadjuvant treatment as another option.…”

Paclitaxel, Carboplatin, and Bevacizumab in Advanced Cervical Cancer: A Treatment Response and Safety Analysis

“…9 However, the phase II trial reported that the addition of bevacizumab to carboplatin-paclitaxel chemotherapy is effective for advanced or recurrent cervical cancer women with hematologic adverse effects. 3 Randomized clinical trials are generally accepted for predicting the efficacy and the safety of a new drug entity, 10 but they are conducted in highly selective patients. Therefore, there are gaps between clinical trials and clinical practice.…”