No Clear Choice for Second-Line Therapy in Advanced Cervical Cancer

Patients with advanced cervical cancer receive a variety of second-line treatment regimens, according to a study published in Gynecologic Oncology.

Researchers evaluated real-world treatment patterns in a cohort of patients with recurrent or metastatic cervical cancer. 

The results showed that most patients received standard first-line therapy, but second-line treatment regimens varied, and 52% of patients did not receive any second-line treatment. 

For this retrospective study, researchers analyzed data from The US Oncology Network. The data encompassed 262 patients with recurrent or metastatic cervical cancer who had received first-line systemic therapy from September 2014 through December 2019. Patients were followed through December 2020. 

The mean age at the start of first-line treatment was 53 years, and 54.6% of patients had an ECOG performance status of 0-1. Most patients had squamous cell histology (68.3%) or adenocarcinoma (23.3%). Some patients had received radiotherapy (63.4%) or had undergone surgery (37.0%) prior to the index date.

The most common first-line systemic treatments were platinum doublet chemotherapy plus bevacizumab (66.4%) or doublet chemotherapy only (23.7%). The median time to discontinuation of first-line therapy was 3.5 months.

All 262 patients completed first-line treatment, and 125 (47.7%) went on to receive second-line therapy. Second-line regimens varied, with 39 patients receiving combination therapy, 35 receiving pembrolizumab alone, 5 receiving bevacizumab alone, 40 receiving other monotherapy, and 6 enrolling on a clinical trial.

There were 137 patients (52.2%) who did not initiate second-line treatment. In this group, 55 patients discontinued first-line treatment and died, 31 had disease progression on first-line therapy, 23 completed first-line treatment with no disease progression, 25 were lost to follow-up, and 3 were still on first-line therapy at last follow-up.

These findings suggest that most patients with recurrent or metastatic cervical cancer receive the current standard of care as first-line treatment, but many do not proceed to second-line therapy, and there is “no clear single choice of therapy” in the second line, the researchers concluded.

Disclosures: This study was supported by Seagen, Inc. Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.

Reference

Alholm Z, He D, Ting J, et al. Real-world treatment drop-off among recurrent or metastatic cervical cancer patients: A US community oncology-based analysis. Gynecol Oncol. Published online July 29, 2022. doi:10.1016/j.ygyno.2022.07.026

This article originally appeared on Cancer Therapy Advisor