No standard treatment is available for 2nd line, especially for patients who experience anaphylaxis to platinum, or develop early recurrence. Previously, we reported 4 cases treated with 50 mg of oral cyclophosphamide daily and 15 mg/kg of intravenous bevacizumab every 3 weeks (mCPA-BEV). Here, we report follow up of the 4 cases and the additional cases.
Methods Patients with cervical cancer who had anaphylaxis to platinum or who recurred less than 6 months after the last administration of cisplatin, and treated with mCPA-BEV were retrospectively reviewed. Adverse events and response rate were recorded according to CTCAE ver 5.0 and RECIST ver 1.1, respectively.
Results During 2016 and 2020, 11 patients were enrolled. Histology of the tumor were SCC in 6, adeno in 3, adeno-SCC in 1, and LCNEC in 1. Two patients had platinum anaphylaxis, 7 patients had progressive disease during previous chemotherapy, and 2 patients recurred within 6 months. One patient suffered from grade 3 neutropenia; however, no grade 2 or higher non-hematological toxicities were observed. Median duration of chemotherapy was 4.1M (range 0.2–30.6 M). One patient had CR in RECIST criteria, and none had PR. Median PFS was 4.1 months (95%CI: 2.1–11.3M), and median OS was 33.7M (95%CI: 13.5–33.7M, figure 1).
Conclusion The tumor dormancy was probably maintained by long administration with mild toxicities. These cases demonstrate the use of mCPA-BEV with minimal toxicity and expected anti-cancer activity and indicate that this regimen could be considered for the second-line chemotherapy in advanced recurrent cervical cancer.
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