Synergistic therapeutic effect of low-dose bevacizumab with cisplatin-based chemotherapy for advanced or recurrent cervical cancer

Abstract

Background: Cisplatin-based chemotherapy (CBC) is highly efficacious for advanced cervical cancer; its efficacy can be enhanced by combining with 15 mg/kg (standard dose) bevacizumab (BEV). However, this standard dose is associated with various adverse events (AEs). Therefore, in this retrospective study, we analyzed the survival outcomes and AEs in patients with advanced or recurrent cervical cancer treated with CBC in combination with BEV 7.5 mg/kg. Methods: Registered patient data were retrieved between October 2014 and September 2019, and 64 patients with advanced or recurrent cervical cancer treated with CBC + BEV (n = 21) or CBC alone (n = 43) were analyzed. The primary endpoints were progression-free survival (PFS) and overall survival (OS); the secondary endpoints were the frequency and severity of AEs. The Cox proportional-hazards model was applied to explore prognostic factors associated with PFS and OS. Results: The 1-, 2-, and 3-year PFS rates (95% CI) were 36.24% (22.0-50.5), 20.7% (9.8-34.2), and 17.7% (7.7-31.1) for the CBC group; and 71.4% (47.1-86.0), 51.0% (27.9-70.1), and 51.0% (27.9-70.1) for the CBC + BEV group, respectively. The 1-, 2-, and 3-year OS rates were 62.6% (46.4-75.18), 32.4% (18.8-46.9), and 23.2% (11.2-37.6) for the CBC group; and 85.7% (61.9-95.1), 66.6% (42.5-82.5), and 55.5% (27.1-76.7) for the CBC + BEV group, respectively. The CBC + BEV group presented higher PFS and OS rates, p = 0.003 and p = 0.005, respectively. Proteinuria (6 vs 9, p = 0.025) and hypertension (0 vs 10, p < 0.001) were less common, but anemia was more common in the CBC group (35 vs 11, p = 0.021). Conclusion: Overall, CBC + BEV significantly improved the PFS and OS compared with CBC alone. CBC + BEV also prevents severe AEs and hence is an efficacious and safe therapeutic option.

To Do One and To Get More: Part II. Diabetes and metabolic dysfunction-associated fatty liver diseases

“…Metformin, an AMPK activator, is considered the first-line agent for pre-DM and DM, except for those patients with poor estimated glomerular filtration rate (<30 mL/min). 30,33,36,60,112,[117][118][119][120] Unfortunately, there are several RCTs that failed to support the effectiveness of metformin in the prevention and treatment of MAFLD, suggesting no improvement in MASH stages in patients treated with metformin. 101,112,116,117 By contrast, reports suggested that the use of metformin may decrease the risk of developing HCC (hazard ratio [HR], 0.25) in MAFLD as well as decrease the overall mortality of patients with liver cirrhosis and DM (HR, 0.42).…”

“…25,26 There are many strategies applicable to DM control, such as lifestyle modification, routine and continuous blood glucose monitoring, and pharmacological therapy (antidiabetic agents [ADA] and sugar-lowering drugs), 27–30 and all of them attempt to minimize DM-related adverse events (AEs) and maintain the quality of life, similar to the therapy for other troublesome diseases by multiple modality strategy. 31–33…”

Classification of Vascular Hotspots and Micro-Vessel Flow Velocity Waveforms in Low-Grade Squamous Intraepithelial Lesions and HPV Condyloma of the Cervix

“…These abnormal areas of tissue may become cancerous. Numerous studies have demonstrated that angiogenesis and the vascularity of cervical cancer correlate with the individual tumor characteristics and prognostic factors for recurrence [ 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 ].…”

Outstanding research paper awards of the Journal of the Chinese Medical Association in 2021

“…A big congratulation is given to Dr. Li-Chun Liu as the 2021 Journal of the Chinese Medical Association Outstanding Research Paper Award winner who is selected from all authors having contributed their research works to the Journal of the Chinese Medical Association (JCMA) last year. [1][2][3][4][5][6] This year's award, sponsored by the Chinese Medical Association-Taipei (CMA-Taipei), is granted to researchers who demonstrate their excellent performance and great contribution to enhanced better patients' care. Dr. Liu won this credit at the Annual Meeting of the CMA-Taipei on July 16, 2022, held at Taipei, Taiwan, and the meeting is still affected apparently by the emergence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease 2019 [COVID-19]) pandemic.…”