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Adding atezolizumab to bevacizumab and platinum-based chemotherapy can improve outcomes in patients with metastatic, persistent, or recurrent cervical cancer, according to data presented in an ESMO Virtual Plenary session.
Researchers found that patients who received atezolizumab plus bevacizumab and chemotherapy had superior progression-free survival (PFS) and overall survival (OS), when compared to patients who received bevacizumab and chemotherapy only.
“These results indicate that atezolizumab in combination with bevacizumab added to platinum-based chemotherapy should be considered a new first-line therapy option for patients with metastatic, persistent, or recurrent cervical cancer,” said study presenter Ana Oaknin, MD, PhD, of Vall d’Hebron Institute of Oncology in Barcelona.
These results come from the phase 3 BEATcc trial (ClinicalTrials.gov identifier: NCT03556839), which included 410 patients with metastatic, persistent, or recurrent cervical cancer who had received no prior systemic therapy for recurrent or metastatic disease.
The patients were randomly assigned to receive atezolizumab plus bevacizumab and chemotherapy (n=206) or bevacizumab and chemotherapy (n=204). Chemotherapy consisted of paclitaxel and cisplatin or carboplatin. Baseline characteristics were generally well balanced between the treatment arms.
Patients in both arms were treated until disease progression or unacceptable toxicity. However, those who achieved a complete response after a minimum of 6 cycles could discontinue chemotherapy and continue with biologic therapy.
At a median follow-up of 32.9 months, there was a 38% reduction in the risk of progression or death and a 32% reduction in the risk of death with atezolizumab.
The median PFS was 13.7 months with atezolizumab and 10.4 months with bevacizumab and chemotherapy (hazard ratio [HR], 0.62; 95% CI, 0.49-0.78; P <.0001).
The median OS was 32.1 months in the atezolizumab arm and 22.8 months in the bevacizumab-chemotherapy arm (HR, 0.68; 95% CI, 0.52-0.88; P =.0046).
The objective response rate was 84% with atezolizumab and 72% with bevacizumab and chemotherapy. The complete response rate was 32% and 20%, respectively. The median duration of response was 13.6 months and 8.6 months, respectively.
The rate of grade 3 or higher adverse events (AEs) was 79% in the atezolizumab arm and 75% in the bevacizumab-chemotherapy arm. There were 3 fatal treatment-related AEs in the atezolizumab arm (vaginal hemorrhage, obstructive jaundice, and ileal perforation) and none in the bevacizumab-chemotherapy arm.
The most common grade 3 or higher all-cause AEs (in the experimental and control arms, respectively) were peripheral/sensory neuropathy (54% and 51%), asthenia (52% in both arms), and nausea (49% and 48%).
“[B]EATcc confirms the clinical benefit of combining immunosuppression inhibition with angiogenesis inhibition in recurrent, metastatic cervical cancer,” Dr Oaknin said.
Disclosures: This research was funded by F. Hoffmann-La Roche Ltd. Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.
Reference
Oaknin A, Gladieff L, Martinez-Garcia J, et al. Primary results from BEATcc (ENGOT-Cx10/GEICO 68-C/JGOG1084/GOG-3030), a randomised phase III trial of first-line atezolizumab (atezo) combined with a platinum doublet and bevacizumab (bev) for metastatic (stage IVB), persistent or recurrent cervical cancer (R/M CC). ESMO Virtual Plenary. November 3, 2023. Abstract VP5-2023.
This article originally appeared on Cancer Therapy Advisor
