European journal of obstetrics, gynecology, and reproductive biology · 2026
Survival trends among patients with newly diagnosed stage IVB cervical cancer before and after the approval of bevacizumab and immunotherapy.
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Wu San-Gang, Hong Shan-Shan, Tang Ya-Ling, Zhou Juan
Аннотация
PURPOSE: In 2014 and 2018, the Food and Drug Administration approved bevacizumab (BEV) and immune checkpoint inhibitors (ICI) for recurrent, persistent, or metastatic cervical cancer (CC), respectively. However, population-based survival benefit studies after the introduction of BEV and ICI are lacking. This study aimed to evaluate outcomes of patients with newly diagnosed stage IVB CC before and after the approval of BEV and ICI.
METHODS: We retrospectively included patients diagnosed between 2004 and 2022 using data from the Surveillance, Epidemiology, and End Results Program. Treatment periods were stratified based on key regulatory approvals: 2004-2013 (pre-BEV era), 2014-2017 (BEV era), and 2018-2022 (BEV + ICI era).
RESULTS: A total of 4,770 patients were included. Significant improvements in 3-year cancer-specific survival (CSS) (30.6% vs. 26.4%, P < 0.001) and overall survival (OS) (3-year 35.9% vs. 24.5%, P = 0.012) were observed in the BEV era than in the pre-BEV era. However, no additional benefits in CSS (P = 0.661) and OS (P = 0.632) were observed in the BEV + ICI era than in the BEV era. Multivariable prognostic analysis yielded similar results. Subgroup analyses revealed better outcomes in younger patients, those with squamous cell carcinoma, advanced tumor stage, and positive regional lymph nodes. Notably, patients who did not undergo local treatment exhibited improved CSS (P = 0.034) and OS (P = 0.019) in the BEV + ICI era than those in the BEV era.
CONCLUSIONS: This study highlights the impact of BEV in stage IVB CC but underscores the need for further optimization of ICI strategies in this population.
METHODS: We retrospectively included patients diagnosed between 2004 and 2022 using data from the Surveillance, Epidemiology, and End Results Program. Treatment periods were stratified based on key regulatory approvals: 2004-2013 (pre-BEV era), 2014-2017 (BEV era), and 2018-2022 (BEV + ICI era).
RESULTS: A total of 4,770 patients were included. Significant improvements in 3-year cancer-specific survival (CSS) (30.6% vs. 26.4%, P < 0.001) and overall survival (OS) (3-year 35.9% vs. 24.5%, P = 0.012) were observed in the BEV era than in the pre-BEV era. However, no additional benefits in CSS (P = 0.661) and OS (P = 0.632) were observed in the BEV + ICI era than in the BEV era. Multivariable prognostic analysis yielded similar results. Subgroup analyses revealed better outcomes in younger patients, those with squamous cell carcinoma, advanced tumor stage, and positive regional lymph nodes. Notably, patients who did not undergo local treatment exhibited improved CSS (P = 0.034) and OS (P = 0.019) in the BEV + ICI era than those in the BEV era.
CONCLUSIONS: This study highlights the impact of BEV in stage IVB CC but underscores the need for further optimization of ICI strategies in this population.