Dr. Leath on Challenges With Bevacizumab in Cervical Cancer

Charles A. Leath, III, MD, gynecologic oncologist, The University of Alabama at Birmingham, discusses challenges with bevacizumab (Avastin) in the treatment of patients with cervical cancer.

Investigators were initially excited to see that the combination of standard chemotherapy with the antiangiogenic agent bevacizumab did improve overall survival, but this is only a temporary survival benefit, Leath says. These patients will inevitably recur, and the median survival for these patients is somewhere between 4 months and 8 months.

Bevacizumab is a very expensive drug, although cost is becoming less of an issue as most payers are accepting coverage of it, Leath adds. However, the agent carries some significant toxicity concerns. Long-term follow-up data presented by Krishnansu S. Tewari, MD, of the University of California, Irvine, show fistula rates around 15%. This is critical to note, says Leath, because fistula rates usually require surgical intervention. Therefore, bevacizumab is providing non-curative therapy with a high toxicity rate.