The safety and efficacy of bevacizumab in the treatment of patients with recurrent or metastatic cervical cancer

ABSTRACT

Introduction: Bevacizumab is a recombinant humanized monoclonal antibody against vascular endothelial growth factor (VEGF). (Avastin; Genetech, Inc, San Francisco, CA) Angiogenesis is blocked by the binding of bevacizumab to VEGF, inhibiting the binding of this ligand to the VEGF receptor. On 14 August 2014 the Food and Drug Administration (FDA) approved use of bevacizumab in persistent, recurrent, or metastatic cervical cancer.

Areas covered: Herein we review pharmacodynamics and kinetics, clinical data and treatment-related toxicities of bevacizumab in the treatment of metastatic, recurrent or persistent cervical cancer. Additionally, future areas of development are reviewed.

Expert commentary: Anti-angiogenesis therapy with bevacizumab is central to metastatic, persistent, and recurrent cervical cancer treatment. Additional anti-angiogenesis drugs are in development. Future studies will need to establish if the addition of multiple anti-angiogenesis agents or anti-angiogenesis in combination with immunotherapy is more effective than bevacizumab with chemotherapy.

KEYWORDS:

• Bevacizumab
• advanced cervical cancer
• anti-angiogenesis therapy

Declaration of interest

K Tewari has received grants from Genentech, Amgen, Endocyte, Tesaro, Astra Zeneca, and Aeterna Zentaris, has acted as a consultant for Caris, Clovis, Advaxis and Roche and has received speakers’ bureau from Astra Zeneca, Merck and Roche. K Tewari was the Principal Investigator and Study Chair of Gynecologic Oncology Group protocol which met its primary endpoint and led directly to US FDA approval of bevacizumab for advanced cervical cancer. Although I was not paid in this role, after publication of the manuscript in the New England Journal of Medicine I participated in two paid Genentech Advisory Boards so that I could be involved in the regulatory discussions to help get this drug to patients who need it and I am currently on the Genentech/Roche speaker’s bureau. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Additional information

Funding

This paper was supported by the Ruth L Kirschstein National Research Service Award Institutional Training Grant, NIH T32 CA-060396-11 awarded to the University of California, Irvine.