Paclitaxel-carboplatin plus bevacizumab therapy for advanced neuroendocrine carcinoma of the uterine cervix: A retrospective case series

J Obstet Gynaecol Res. 2023 Dec;49(12):2868-2874. doi: 10.1111/jog.15783. Epub 2023 Sep 2.

Abstract

Aim: There is no conclusive data on the prognosis of patients who receive paclitaxel-carboplatin (TC) plus bevacizumab therapy for advanced neuroendocrine carcinoma (NEC) of the uterine cervix, a rare histological subtype of cervical cancer. Thus, the aim of this study was to determine the efficacy of TC chemotherapy plus bevacizumab and bevacizumab single maintenance therapy for advanced NEC of the cervix.

Methods: This was a retrospective review of patients who received TC plus bevacizumab therapy for metastatic, recurrent, or persistent NEC of the cervix at seven institutions between 2015 and 2020. Relevant data were extracted from the patients' medical records and analyzed.

Results: Seven patients, including six with small-cell NEC and one with large-cell NEC, were included for analysis. Three patients received bevacizumab single maintenance therapy following TC plus bevacizumab therapy, whereas four patients did not receive bevacizumab single maintenance therapy. The median overall survival and progression-free survival of the patients who received bevacizumab single maintenance therapy were longer than those of the patients who did not receive the therapy (34 months vs. 10.5 months and 19 months vs. 5 months, respectively). However, the patients who received bevacizumab single maintenance therapy had received cisplatin-based chemotherapy previously.

Conclusions: On the premise that cisplatin-based chemotherapy is administered as the first-line treatment for advanced NEC of the cervix, bevacizumab single maintenance therapy following TC plus bevacizumab may be considered the second- or third-line treatment. However, the risk of adverse events, such as intestinal perforation, should be discussed with patients.

Keywords: bevacizumab; chemotherapy; neuroendocrine carcinoma; small-cell carcinoma; uterine cervical cancer.

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Bevacizumab / therapeutic use
  • Carboplatin
  • Carcinoma, Neuroendocrine* / drug therapy
  • Cervix Uteri / pathology
  • Cisplatin / therapeutic use
  • Female
  • Humans
  • Paclitaxel / therapeutic use
  • Retrospective Studies
  • Uterine Cervical Neoplasms* / pathology

Substances

  • Bevacizumab
  • Carboplatin
  • Paclitaxel
  • Cisplatin