The following is a summary of “Combination therapy with topotecan, paclitaxel, and bevacizumab improves progression-free survival in patients with recurrent high-grade neuroendocrine cervical cancer: a Neuroendocrine Cervical Tumor Registry (NeCTuR) study,” published in the APRIL 2023 issue of Obstetrics and Gynecology by Frumovitz, et al.

Recurrent high-grade neuroendocrine cervical cancer carries a grim prognosis and limited treatment options. Therefore, the effectiveness of the 3-drug combination of topotecan, paclitaxel, and bevacizumab in women with recurrent high-grade neuroendocrine cervical cancer needs to be evaluated. Therefore, for a retrospective cohort study, researchers sought to assess the efficacy of the topotecan, paclitaxel, and bevacizumab regimen in women with recurrent high-grade neuroendocrine cervical cancer and to compare it with other chemotherapy regimens.

Data from the Neuroendocrine Cervical Tumor Registry (NeCTuR) were used for the study. The registry contained medical records of women diagnosed with high-grade neuroendocrine carcinoma of the cervix from English- and Spanish-speaking countries. Women who received the topotecan, paclitaxel, and bevacizumab regimen as first- or second-line therapy for recurrence were compared with those who received different chemotherapy regimens. The study evaluated progression-free survival, overall survival, and response rates.

They included 62 patients who received the topotecan, paclitaxel, and bevacizumab regimen and 56 who received alternative chemotherapy for recurrence. The median progression-free survival was 8.7 months in the topotecan, paclitaxel, and bevacizumab group compared to 3.7 months in the non-regimen group, with a hazard ratio for disease progression of 0.27 (95% CI, 0.17–0.48; P < .0001). In the regimen group, stable disease was observed in 15% of patients, partial response in 39%, and complete response in 18%. In addition, the retention rate on treatment at six months was significantly higher in the regimen group compared to the non-regimen group (67% vs. 31%, respectively; P = .0004), and the same was observed at 1 year (24% vs. 9%, respectively; P = .02). The median overall survival was 16.8 months in the regimen group and 14.0 months in the non-regimen group, with a hazard ratio for death of 0.87 (95% CI, 0.55–1.37).

Topotecan, paclitaxel, and bevacizumab combination therapy demonstrated efficacy in women with recurrent high-grade neuroendocrine cervical cancer. It resulted in improved progression-free survival and a lower hazard ratio for disease progression compared to other chemotherapy regimens.

Source: ajog.org/article/S0002-9378(22)02270-0/fulltext