Junker, Philip, Puppe, Julian, Thangarajah, Fabinshy, Domroese, Christian, Cepic, Angela, Morgenstern, Bernd, Ratiu, Dominik, Hellmich, Martin, Mallmann, Peter and Writz, Marina (2018). Neoadjuvant Therapy of Cervical Carcinoma with the Angiogenesis Inhibitor Bevacizumab: a Single-Centre Analysis. Geburtshilfe Frauenheilkd., 78 (8). S. 768 - 775. STUTTGART: GEORG THIEME VERLAG KG. ISSN 1438-8804

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Abstract

Introduction Cervical cancer is the fourth most frequent cancer in women worldwide. Addition of the VEGF antibody bevacizumab in combination with platinum-containing chemotherapy achieved an improvement in overall survival in advanced cervical cancer. To date there are no data on neoadjuvant use of bevacizumab. We therefore studied the benefit of neoadjuvant combined therapy with bevacizumab in a group of cervical cancer patients. Patients and Methods This retrospective cohort study analysed 14 patients with cervical cancer FIGO stages 1b1 to IV who received neoadjuvant platinum-containing chemotherapy in combination with bevacizumab. The comparative cohort consisted of 16 patients who were treated with neoadjuvant platinum-containing chemotherapy alone. The response rates were determined by means of preoperative clinical examination, diagnostic imaging (RECIST), changes in tumour markers (SCC) and by histopathology. Results A clinical response was found in 93.8% (n = 15) of patients after bevacizumab-free therapy and in 100% (n = 14) of the patients who were treated with bevacizumab in addition. Combined therapy with bevacizumab led to a higher rate of clinical complete remission (42.9 vs. 12.5%; p = 0.072) and significantly improved the reduction in tumour size (Delta longest diameter: 3.7 vs. 2.5 cm; p = 0.025). Downgrading was observed in 100% of all patients treated with bevacizumab compared with 75% in the control arm. The rate of pathological complete remission (pCR) was not altered significantly (28.6% [n = 4] vs. 37.5% [n = 6]; p = 0.460). Discussion Overall, combined therapy with bevacizumab led to a better clinical response. Operability was therefore improved more often. Because of the small patient cohort, larger prospective studies are necessary to validate the effect of neoadjuvant combined therapy with bevacizumab.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Junker, PhilipUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Puppe, JulianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Thangarajah, FabinshyUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Domroese, ChristianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Cepic, AngelaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Morgenstern, BerndUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ratiu, DominikUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hellmich, MartinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mallmann, PeterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Writz, MarinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-178176
DOI: 10.1055/a-0641-5588
Journal or Publication Title: Geburtshilfe Frauenheilkd.
Volume: 78
Number: 8
Page Range: S. 768 - 775
Date: 2018
Publisher: GEORG THIEME VERLAG KG
Place of Publication: STUTTGART
ISSN: 1438-8804
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
GYNECOLOGIC-ONCOLOGY-GROUP; RADIATION-THERAPY; SOLID TUMORS; CANCER; SURVIVAL; CHEMOTHERAPY; RADIOTHERAPY; EFFICACY; MARKERS; IIAMultiple languages
Obstetrics & GynecologyMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/17817

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