Safe administration of bevacizumab combination chemotherapy for the patients with recurrent cervical cancer after pelvic radiotherapy: Two case reports

Abstract

In Japan, bevacizumab has not been proven either effective or safe for the treatment of recurrent cervical cancer. The present study reported two cases in which bevacizumab combination chemotherapy was safely administered for recurrent cervical cancer following pelvic radiotherapy. Case 1 was a 62-year-old woman with stage IIIB squamous cell carcinoma of the cervix who had received whole pelvic external beam radiotherapy (WPEBRT) at a dose of 50.4 Gy and high dose rate intra-cavitary brachytherapy at a dose of 24 Gy to the pelvis one year earlier. For recurrent cervical cancer, chemotherapy with paclitaxel, carboplatin and bevacizumab was administered for six cycles. Case 2 was a 52-year-old woman with stage IIB squamous cell carcinoma of the cervix who had received WPEBRT at a dose of 50.4 Gy to the pelvis 11 years earlier. For lymph node and liver metastases, chemotherapy with paclitaxel, cisplatin, and bevacizumab was administered for six cycles. Although grade 2 proteinuria was observed in one of these patients, there were no intestinal perforation, fistula, hypertension, proteinuria or thrombosis events, which are the characteristic adverse reactions associated with bevacizumab. Hematotoxicity was also manageable. Regarding the antitumor effect, case 1 demonstrated a complete response, whereas case 2 resulted in stable disease.

Cervical cancer therapies: Current challenges and future perspectives

“…Chemotherapy is often used in combination with radiotherapy to treat cervical cancer and this reduces tumour volume, inhibits micro-metastasis, and prevents damage repair and drug resistance, and increases radio-sensitivity of hypoxic cells in the cervix [ [140] , [141] , [142] ]. Studies have also explored combining immunotherapy and chemotherapy as initial immunotherapy is capable of sensitizing cervical cancer tumours to subsequent chemotherapy.…”

Tumor Organoid and Spheroid Models for Cervical Cancer

“…Different combinations of chemotherapy with either radiotherapy, immunotherapy, or targeted therapy are often tested. Most frequently, cervical cancer is treated with a combination of chemoand radiotherapy [135].…”

“…Combining targeted agents with chemotherapy showed increased efficacy against cervical cancer [135,136]. For instance, while VEGF antibody monotherapy showed limited anti-tumor efficacy in cervical cancer in the clinic, combination with standard chemotherapeutic drugs prolonged progression-free and overall survival [135].…”

“…Combining targeted agents with chemotherapy showed increased efficacy against cervical cancer [135,136]. For instance, while VEGF antibody monotherapy showed limited anti-tumor efficacy in cervical cancer in the clinic, combination with standard chemotherapeutic drugs prolonged progression-free and overall survival [135]. The combination of bevacizumab with cisplatin or paclitaxel resulted in more frequent complete response and improved median overall survival of a few months compared to chemotherapy alone [137].…”