Dr. Monk on the Significance of Bevacizumab in Cervical Cancer

Bradley J. Monk, MD, FACS, FACOG, co‐director of GOG Partners, Arizona Oncology (US Oncology Network); professor of Gynecologic Oncology at University of Arizona, Creighton University; and medical director of the US Oncology Research Gynecology Program, discusses the FDA approval of bevacizumab (Avastin) and other novel agents in cervical cancer.

In the setting of metastatic cervical cancer, or when the cancer has spread to the lungs, liver, or lymph nodes, the standard treatment was a regimen examined in the GOG 240 trial, the results of which were published in the New England Journal of Medicine, says Monk. In the trial, patients were randomized to receive chemotherapy with or without bevacizumab. The addition of bevacizumab to chemotherapy was associated with increased overall survival, at 17.0 months versus 13.3 months with chemotherapy alone; higher response rates were also observed with the combination.

Results from this trial led to the 2014 FDA approval of the antiangiogenic bevacizumab; this was the first targeted therapy to receive approval in cervical cancer. Specifically, the indication is for bevacizumab to be used in combination with paclitaxel and either cisplatin or topotecan. Essentially, investigators took a doublet regimen in this space comprised of chemotherapy and turned it into a triplet regimen with the addition of bevacizumab, says Monk. The triplet is now the global standard and it is approved for use around the world, adds Monk. Bevacizumab was the first approved targeted therapy to receive approval in this space in the United States, and ultimately, it improves survival by around 4 months, concludes Monk.