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Comparative Study
. 2017 Jan;144(1):46-50.
doi: 10.1016/j.ygyno.2016.10.040. Epub 2016 Nov 4.

Combination therapy with topotecan, paclitaxel, and bevacizumab improves progression-free survival in recurrent small cell neuroendocrine carcinoma of the cervix

M Frumovitz  1 , M F Munsell  2 , J K Burzawa  3 , L A Byers  4 , P Ramalingam  5 , J Brown  6 , R L Coleman  3
Affiliations
Comparative Study

Combination therapy with topotecan, paclitaxel, and bevacizumab improves progression-free survival in recurrent small cell neuroendocrine carcinoma of the cervix

M Frumovitz et al. Gynecol Oncol. 2017 Jan.

Abstract

Objectives: To assess if the combination of topotecan, paclitaxel, and bevacizumab (TPB) was active in recurrent SCCC and to compare the survival of patients with SCCC who received TPB to a group of women with SCCC who did not receive this regimen.

Methods: We retrospectively analyzed women with recurrent SCCC who received chemotherapy as primary therapy. Women treated with TPB for first recurrence were compared to women treated with non-TPB chemotherapy.

Results: Thirteen patients received TPB, and 21 received non-TPB chemotherapy, most commonly platinum with or without a taxane. Median progression-free survival (PFS) was 7.8months for TPB and 4.0months for non-TPB regimens (hazard ratio [HR] 0.21, 95% CI 0.09-0.54, P=0.001). Median overall survival (OS) was 9.7months for TPB and 9.4months for non-TPB regimens (HR 0.53, 95% CI 0.23-1.22, P=0.13). Eight women (62%) who received TPB versus four (19%) who received non-TPB regimens were on treatment for >6months (P=0.02), and four patients (31%) in the TPB group versus two (10%) in the non-TPB group were on treatment for >12months (P=0.17). In the TPB group, three patients (23%) had complete response, two (15%) had complete response outside the brain with progression in the brain, 3 (23%) had a partial response, 2 (15%) had stable disease, and 3 (23%) had progressive disease.

Conclusions: These findings indicate that TPB for recurrent SCCC significantly improved PFS over non-TPB regimens, and trends towards improved OS. Furthermore, a significant number of patients had a durable clinical benefit.

Keywords: Cervical cancer; Neuroendocrine; Small cell carcinoma.

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Conflict of interest statement

Disclosure: The authors have declared no conflicts of interest

Figures

Figure 1
Figure 1
Progression-free survival in patients with small cell cervix cancer treated with topotecan, paclitaxel, and bevacizumab (TPB) or only with non-TPB regimens as primary therapy for first recurrence.
Figure 2
Figure 2
Overall survival in patients with small cell cervix cancer treated with topotecan, paclitaxel, and bevacizumab (TPB) or only with non-TPB regimens as primary therapy for first recurrence.
See this image and copyright information in PMC

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