Dr Farolfi on a Real-World Study of Bevacizumab Plus SOC Therapy in Cervical Cancer

“I would suggest every time it is possible or not contraindicated to add bevacizumab to [SOC therapy] for [the treatment of] these patients. The type of platinum-[based chemotherapy] is not very important.”

Alberto Farolfi, MD, PhD, a medical oncologist at Romagnolo Scientific Institute for the Study and Treatment of Tumors, discussed the potential clinical implications of a real-world study evaluating frontline bevacizumab (Avastin) in combination with standard-of-care (SOC) platinum-based chemotherapy and pembrolizumab (Keytruda) for the treatment of patients with advanced cervical cancer and no contraindications for antiangiogenic agents.

During the 2025 ESMO Gynecological Cancers Congress, Farolfi presented data showing that patients who received bevacizumab plus cisplatin, a taxane, and pembrolizumab experienced a significant survival benefit compared with those who received cisplatin, a taxane, and pembrolizumab (HR, 0.48; 95% CI, 0.31-0.72; P < .001). Additionally, a benefit in favor of the bevacizumab combination was observed when carboplatin was substituted for cisplatin in both arms (HR, 0.62; 95% CI, 0.47-0.82; P = .001).

In terms of safety, patients who received cisplatin, paclitaxel, and pembrolizumab with bevacizumab (n = 170), cisplatin, paclitaxel and pembrolizumab (n = 170), carboplatin, paclitaxel and pembrolizumab with bevacizumab (n = 345), and carboplatin, paclitaxel and pembrolizumab (n = 345) experienced fistula toxicities at respective rates of 12.4%, 14.1%, 10.1%, and 10.1%. The rates of bowel perforation were 1.2%, 0.6%, 0.9%, and 0.6%, respectively. The rates of pulmonary embolism were 7.1%, 8.2%, 6.4%, and 9.6%, respectively.

In light of these data, bevacizumab should be added to the SOC regimen for the treatment of patients with advanced cervical cancer when it is possible and not contraindicated, Farolfi said. He also noted that the type of platinum-based chemotherapy that is used in the regimen is not of great importance.