Combination of weekly paclitaxel-carboplatin plus standard bevacizumab as neoadjuvant treatment in stage IB–IIB cervical cancer

Abstract

ObjectiveIn this study we investigated response rates of bevacizumab in addition to weekly paclitaxel and carboplatin in neoadjuvant setting in cervical cancer stage IB–IIB.MethodsIn this retrospective study we included patients with FIGO 2018 stage IB–IIB cervical cancer. Treatment consisted of 9 weeks' neoadjuvant paclitaxel and carboplatin (paclitaxel 60 mg/m2, carboplatin AUC 2.7; both weekly) and bevacizumab (15 mg/kg every 3 weeks). The radiologic response rate was analyzed using the Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 criteria. The definition of optimal pathological response was complete disappearance of tumor (complete response, pCR) or residual disease with less than 3 mm stromal invasion (pPR1). Suboptimal pathologic response (pPR2) was defined as persistent residual disease with more than 3 mm stromal invasion.ResultsA total of 30 patients were included. Six patients had FIGO 2018 stage IB1–IB2 (20%), one had stage IB3 (3%), five had stage IIA (17%), and 18 had stage IIB (60%). After completing the neoadjuvant chemotherapy, all patients showed a RECIST response (seven (23%) complete response; 23 (77%) partial response). Six patients (20%) were judged to be still inoperable. After radical hysterectomy, optimal pathological response was observed in 11 patients (38%) (pCR in nine patients (29%) and pPR1 in two patients (8%)). Six patients (20%) received postoperative adjuvant chemoradiotherapy. Hematological toxicity was similar to neoadjuvant weekly paclitaxel and carboplatin, as we reported earlier. Grade IV proteinuria or hypertension was not observed and no administration of bevacizumab was delayed or dose-reduced.ConclusionBevacizumab in addition to weekly paclitaxel and carboplatin showed a 100% radiological RECIST response and an optimal pathological response of 38%. Although bevacizumab has an established role in the treatment of recurrent cervical cancer in combination with paclitaxel and carboplatin, we did not observe a tendency toward superior effect on the pathological response rate of bevacizumab in the neoadjuvant chemotherapy setting.

Laparoscopic Radical Hysterectomy Combined with Neoadjuvant Chemotherapy for Cervical Cancer Patients Effectively Improves Immune Function

“…In addition, neoadjuvant chemotherapy has a strong tumor-killing effect, which reduces tumor load and thus tumor-induced immunosuppression. The denaturation of tumor proteins after chemotherapy treatment induces the formation of other antigens of the same type, which in turn increases the immune function of the body [ 26 , 27 ].…”

Comparison of the clinical efficacy of paclitaxel + carboplatin and paclitaxel + cisplatin on tumor markers and WHOQOL-BREF score on cervical cancer patients

“…Consequently, this impedes mitosis and fosters the demise of tumor cells, yielding potent antitumor effects [16][17][18]. Relevant clinical studies have corroborated these findings, indicating that the preoperative utilization of paclitaxel in the treatment of cervical cancer patients can substantially reduce tumor size, facilitating the complete removal of tumor lesions during subsequent surgical procedures, subsequently diminishing the risk of recurrence and metastasis post-surgery [19,20]. Paclitaxel, cisplatin and carboplatin have all demonstrated individual effectiveness in the treatment of cervical cancer.…”

FNBP1 Facilitates Cervical Cancer Cell Survival by the Constitutive Activation of FAK/PI3K/AKT/mTOR Signaling

“…However, platinum-based chemotherapy has been the backbone treatment in advanced cervical cancer for quite a few years, with no attractive improvements in survival [10]. Although the combination of carboplatin, paclitaxel and bevacizumab have currently become the standard frontline treatment for cervical cancer with encouraging efficacy [11,12], the search for new strategies that can fulfill the urgent need for effective targeted therapeutic approaches remains a major challenge.…”