Researchers affiliated with the Gynecologic Oncology Group have reported that Avastin® (bevacizumab) has significant activity for the treatment of persistent or recurrent squamous cell carcinoma of the cervix. These results were published in the March 1, 2009 issue of the Journal of Clinical Oncology. 

Avastin is a recombinant humanized monoclonal antibody to vascular endothelial growth factor (VEGF). VEGF appears to play an important role in tumor angiogenesis, and blocking this activity should have an anti-tumor effect. Avastin is approved by the Food and Drug Administration for the treatment of non–small cell lung cancer, colorectal cancer, and breast cancer but has activity in a number of tumors including ovarian cancer, small cell lung cancer, brain cancer, prostate cancer, hepatocellular cancer, soft tissue sarcoma, pancreatic cancer, and renal cell cancer. There has been only one report of Avastin for the treatment of cervical cancer. Researchers from Washington University have reported that Avastin in combination with 5-FU or Xeloda® (capecitabine) is active in women with heavily pretreated, recurrent cervical cancer.

To evaluate Avastin in the treatment of recurrent squamous cell carcinoma of the cervix, researchers conducted a Phase II clinical trial among 46 women. Study participants received intravenous Avastin every three weeks until cancer progression or the development of severe side effects.

• 24% of patients survived progression-free for at least six months.
• 11% of patients had a partial response.
• Median response duration was 6.2 months.
• Median overall survival was 7.3 months.
• Median progression-free survival was 3.4 months.
• There was one infection-related death that was possibly due to treatment.
• Side effects included hypertension and thromboembolism

These researchers concluded that Avastin was generally well tolerated and appeared to have anticancer activity in women with previously treated recurrent cervical cancer. They note that the role of Avastin in this population merits further study in Phase III clinical trials. 

Comments: These data suggest single agent activity for Avastin, but future studies are likely to involve combining Avastin with chemotherapy or possibly other targeted agents.

Reference: Monk BJ, Sill MW, Burger RA et al. Phase II trial of bevacizumab in the treatment of persistent or recurrent squamous cell carcinoma of the cervix: a Gynecologic Oncology Group Study. Journal of Clinical Oncology. 2009;27:1069-1074.