A new study published in the New England Journal of Medicine reports on a multi-site research project by Bradley J. Monk, MD and coworkers at the University of Arizona Cancer Centerat St. Joseph’s Hospital and Medical Centerin Phoenix, Arizona.The results of their study expected to change the standard of care for women with advanced cervical cancer.

The featured research revealed that women with advanced cervical cancer live about four months longer with the combined use of bevacizumab (Avastin?; Genentech/Roche) and chemotherapy compared to chemotherapy alone. Women who combined bevacizumab with chemotherapy lived an average of 17 months after diagnosis, while those who received chemotherapy alone lived 13.3 months.

…the results of this study are a significant step forward and now we will move to trying to add bevacizumab to a front-line treatment when cancers are more curable, rather than using it at the time of recurrence…

New treatment options
“This research proves that there are new options for patients with metastatic cervical cancer,” Monk said. “I predict that adding bevacizumab to chemotherapy will become the new standard of care.”

Monk is nationally recognized for his expertise in cervical cancer and chairs the Gynecologic Oncology Cervical Cancer Committee for the National Cancer Institute (NCI) funded Gynecologic Oncology Group.

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Multicenter and International
The research was conducted between April 2009 and January 2012. A total of 452 women participated in the trial and were enrolled from 164 institutions in the United States and Spain. St. Joseph’s Hospital and Medical Center was the only site enrolling in Arizona, USA.

During the clinical trial, patients were randomly assigned to groups who only received chemotherapy and to groups who received both chemotherapy with bevacizumab.

Approximately 12,000 cases of cervical cancer are diagnosed in the United States annually, and with continued increases in vaccinations, numbers of cases are expected to decrease further. However, for vulnerable populations without access to health care, cervical cancers remains a serious problem, with 500,000 new cases and 250,000 deaths annually.

“There has been a large unmet medical need for active treatments for cervical cancer,” Monk noted. “We believe the results of this study are a significant step forward and now we will move to trying to add bevacizumab to a front-line treatment when cancers are more curable, rather than using it at the time of recurrence.”

Ongoing research has shown that anti-angiogenic agents, including bevacizumab, hold great promise in the treatment of gynecologic cancers. Bevacizumab is routinely employed oncologists in treating women with ovarian cancer. A recent survey by Decision Resources, a company analyzing the healthcare industry, showed that that more than 70% of oncologists use bevacizumab in their firstline treatment of patients with ovarian cancer. [3] This is noteworthy. While the drug is approved for the treatment of metastatic colorectal cancer, non-squamous non-small cell lung cancer, glioblastoma, and metastatic renal cell carcinoma, the FDA has not yet approved an indication of this drug for the treatment of use in the disease.

For more information:
[1] Tewari KS, Sill MW, Long HJ 3rd, Penson RT, Huang H, Ramondetta LM Improved survival with bevacizumab in advanced cervical cancer. N Engl J Med. 2014 Feb 20;370(8):734-43. doi: 10.1056/NEJMoa1309748. [Article][PubMed]
[2] Paclitaxel and Cisplatin or Topotecan With or Without Bevacizumab in Treating Patients With Stage IVB, Recurrent, or Persistent Cervical Cancer – NCT00803062 [Study Record Detail]
[3] Decision Resources. The majority of surveyed oncologists prescribe bevacizumab off-label to their ovarian cancer patients. Decision Resources website. Published August 14, 2013; Last accessed on February 20, 2014.

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