High-risk patients with recurrent/advanced cervical cancer may derive the most benefit from antiangiogenesis therapy: A Gynecologic Oncology Group (GOG) study

Tewari, Κ. Κ.; Sill, Michael W.; Moore, D H; Long, Harry J.; Penson, Richard T.; Huang, Helen Q.; Landrum, Lisa M.; Oaknin, Ana; Michael, H.; Monk, Bradley J.; Ramondetta, Lois M.; Reid, Thomas J.; Leitao, Mario M.

doi:10.1016/j.ygyno.2014.03.164

Cited by 5 publications

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“…Previously described poor prognostic factors including African American ethnicity, PS, measureable disease within the pelvis, prior cisplatin, and short progression-free interval were also prognostic in GOG 240. However, the investigators questioned their utility at guiding whether to add bevacizumab as high-risk patients did appear to benefit [ 59 ].…”

Section: Reviewmentioning

confidence: 99%

Breaking down the evidence for bevacizumab in advanced cervical cancer: past, present and future

Rodríguez-Freixinós

Mackay

2015

gynaecol oncol res pract

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Despite the introduction of screening and, latterly, vaccination programs in the developed world, globally cervical cancer remains a significant health problem. For those diagnosed with advanced or recurrent disease even within resource rich communities, prognosis remains poor with an overall survival (OS) of just over 12 months. New therapeutic interventions are urgently required. Advances in our understanding of the mechanisms underlying tumor growth and the downstream effects of human papilloma virus (HPV) infection identified angiogenesis as a rational target for therapeutic intervention in cervical cancer. Anti-angiogenic agents showed promising activity in early phase clinical trials culminating in a randomized phase III study of the humanized monoclonal antibody to vascular endothelial growth factor (VEGF), bevacizumab, in combination with chemotherapy. This pivotal study, the Gynecologic Oncology Group protocol 240, met its primary endpoint demonstrating a significant improvement in OS. Bevacizumab became the first targeted agent to be granted regulatory approval by the United States Food and Drug Administration for use alongside chemotherapy in adults with persistent, recurrent or metastatic carcinoma of the cervix. This review outlines the rationale for targeting angiogenesis in cervical cancer focusing on the current indications for the use of bevacizumab in this disease and future directions.

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Section: Reviewmentioning

confidence: 99%

Breaking down the evidence for bevacizumab in advanced cervical cancer: past, present and future

Rodríguez-Freixinós

Mackay

2015

gynaecol oncol res pract

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“…This represents valuable time that may allow patients to receive other promising novel therapies including other types of angiogenesis treatment or immunotherapy to take advantage of what the forefront of translational research has to offer. Additionally in GOG 240, validation of the Moore criteria for identification of patients with poor prognostic factors not likely to respond to cisplatin-based regimens demonstrated that the highest risk patients benefit the most from angiogenesis inhibition with bevacizumab [31,32].…”

Section: Expert Opinionmentioning

confidence: 99%

Integration of bevacizumab with chemotherapy doublets for advanced cervical cancer

Krill

Tewari

2015

Expert Opinion on Pharmacotherapy

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“…While the mechanism of anti-VEGF therapy-induced hypertension has not been fully elucidated, nitric oxide pathway inhibition, rarefaction and oxidative stress may be critical in its pathogenesis [70]. Although nephrotic syndrome was not observed in GOG 240, glomerular injury may develop with diminished effect of VEGF in maintaining the filtration barrier.…”

Section: Proposed Mechanisms Of Aesmentioning

confidence: 99%

Development of bevacizumab in advanced cervical cancer: pharmacodynamic modeling, survival impact and toxicology

Eskander

Tewari

2015

Future Oncol.

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Historically, patients with metastatic, persistent or recurrent cervical cancer had limited therapeutic options. Despite several Phase II/III clinical trials, the combination of cisplatin and paclitaxel remained the most effective chemotherapeutic regimen. In 2014, publication of Gynecologic Oncology Group 240 represented the emergence of an alternate and effective therapeutic option. This prospective, randomized, Phase III clinical trial explored the impact of adding the antiangiogenic agent bevacizumab to two separate cytotoxic chemotherapy backbones. Importantly, the study met its primary end point, showing a survival advantage of approximately 4 months without detriment in quality of life. As such, a review of bevacizumab and its application in patients with advanced-stage cervical cancer is warranted.

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High-risk patients with recurrent/advanced cervical cancer may derive the most benefit from antiangiogenesis therapy: A Gynecologic Oncology Group (GOG) study

Cited by 5 publications

References 0 publications

Breaking down the evidence for bevacizumab in advanced cervical cancer: past, present and future

Breaking down the evidence for bevacizumab in advanced cervical cancer: past, present and future

Integration of bevacizumab with chemotherapy doublets for advanced cervical cancer

Development of bevacizumab in advanced cervical cancer: pharmacodynamic modeling, survival impact and toxicology

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