Three-drug regimen shows promise in neuroendocrine carcinoma of the cervix

The three-drug regimen consisting of topotecan, paclitaxel, and bevacizumab (TPB) prolongs progression-free survival (PFS) in women with recurrent high-grade neuroendocrine carcinoma of the cervix, as shown in a study.

The retrospective cohort study drew data from the Neuroendocrine Cervical Tumor Registry (NeCTuR), which involved women diagnosed with high-grade neuroendocrine carcinoma of the cervix. Researchers compared the outcomes between 62 patients who received TPB as first- or second-line therapy for recurrence and 56 who received chemotherapy but not TPB.

Treatment was given until disease progression or development of unacceptable toxic effects. The outcomes evaluated were PFS from the start of treatment for recurrence to the next recurrence or death, overall survival from first recurrence, and response rates.

Median PFS was significantly longer with TPB than with non-TPB (8.7 vs 3.7 months; hazard ratio [HR] for progression, 0.27, 95 percent confidence interval [CI], 0.17–0.48; p<0.0001). Among the TPB-treated patients, 15 percent had stable disease, 39 percent had a partial response, and 18 percent had a complete response.

A higher proportion of patients in the TPB vs non-TPB group remained on treatment at 6 months (67 percent vs 31 percent; p=0.0004) and 1 year (24 percent vs 9 percent; p=0.02). Median overall survival was 16.8 months in the TPB group compared to 14.0 months in the non-TPB group (HR for death, 0.87, 95 percent CI, 0.55–1.37).