Sorry, I have not written for a while. I have been busy getting a few papers
published. It was nice from some of you
to send me email to encourage me to keep writing this blog. So here it is.
Women with recurrent, metastatic, or advanced
cervical cancer usually have poor prognosis.
The salvage treatment consists of limited number of chemotherapy. The chemo that are active in this situations
are cisplatin, carboplatin, topotecan and ifosfamide. A recent study (GOG study number 240)
suggests that chemo combined with
angiogenesis inhibitor bevacizumab is more effective than just chemo alone. In this study, over 400 women with stage IVB recurrent or
persistent cervical squamous cell cancer or adenocarcinoma were randomly
assigned to chemotherapy (paclitaxel plus either cisplatin or topotecan)
with or without bevacizumab. Although the final study has not been published,
the interim analysis showed the addition of bevacizumab to chemotherapy
improved overall survival by four months compared to chemotherapy alone (17
versus 13 months).
Unfortunately, the insurance companies have not approved Bevacizumab
for cervical cancer yet for my patients despite my pleas. I am not so surprised since insurance
companies usually wait until final publication as well as NCCN organization’s approval. UT-West clinic is one of the member institutions
for NCCN. Thus, we will try to push this
info to NCCN.
Reference:
NCI Press
Release: Bevacizumab significantly improves survival for patients with
recurrent and metastatic cervical cancer.
http://cancer.gov/newscenter/newsfromnci/2013/GOG240 (Accessed on February 19,
2013
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