Posttreatment squamous cell carcinoma antigen: A prognostic marker for patients with advanced cervical cancer treated with bevacizumab-paclitaxel-cisplatin therapy

Abstract

Cervical cancer is a leading cause of cancer-related mortality in women, with poor prognosis when diagnosed at advanced stages. Bevacizumab, an anti-vascular endothelial growth factor agent, has shown promising results in the treatment of metastatic cervical cancer. The combination of bevacizumab with paclitaxel and cisplatin (TP) as first-line chemotherapy is associated with improved survival rates in patients with metastatic cervical cancer. In this study, we aimed to evaluate the effectiveness and safety of first-line chemotherapy with bevacizumab and TP in patients with advanced cervical cancer in South Korea and investigate the clinical value of posttreatment plasma levels of squamous cell carcinoma antigen (SCC Ag) as an independent prognostic factor for survival. This retrospective study included 33 patients with metastatic cervical cancer who received bevacizumab and TP as first-line chemotherapy between January 2016 and December 2022 at the Gyeongsang National University Hospital. First-line therapy with bevacizumab and TP significantly improved progression-free and overall survival (OS) [26.3 (95% confidence interval (CI), 18.3-34.3) and 39.9 (95% CI, 23.8-56) months, respectively]. Patients who achieved normalization of posttreatment SCC Ag levels had significantly longer OS compared to those who did not [69.1 (95% CI, 17.6-120.6) vs 18.4 (95% CI, 10.9-25.9) months, respectively (hazard ratio 12.4; P < .001)]. The treatment regimen was well-tolerated, with most patients reporting manageable side effects. First-line chemotherapy with bevacizumab and TP demonstrated efficacy and tolerability in Korean patients with metastatic cervical cancer. Additionally, normalization of posttreatment SCC antigen levels serves as a potential prognostic marker for patients undergoing this type of chemotherapy.