ESMO Gynae 2025 | Evaluating bevacizumab with pembrolizumab & chemotherapy in cervical cancer

We presented the ESMO Gynae and a real-world study on the efficacy of pembrolizumab in the first-line setting of cervical cancer, and we analyzed patients based on their companion treatment. I mean, we wanted to evaluate if there were some differences in the treatment and the efficacy if the patient received or not the basis of our so we divided our cohort of patients into four groups based on the companion treatment cisplatin or carboplatin and with or without bevacizumab. The rationale behind this evaluation was that in the seminal trial that came out with the approval of Pembrolizumab, the choice of the platinum was based on the investigator and also the addition of bevacizumab could be on the investigator’s choice. So, there were not so many data on the real efficacy of the combinations. In our evaluation, we presented before at ASCO the analysis on the type of platinum and demonstrating that there were no differences on the type of platinum use. I mean, if it was carboplatin or cisplatin, the efficacy was almost the same. But now, with the data presented at ESMO Gynae, we saw that the addition of bevacizumab could improve the outcome of the patients. I had to remark the possibility that what we saw could be also related to a selection bias of our patients because in clinical practice when we use bevacizumab in addition to our standard regimen, we select patients that maybe could have a more favorable disease. So, this could be also a reason why we saw this kind of difference. But another interesting point that I want to underline is that we also try to figure out if the addition of bevacizumab could enhance some kind of toxicities that could be of very important interest for the physician and could be also very tough for the patients. And we analyzed the rate of fistula and bowel perforation and pulmonary embolism based on the treatment received and we saw that the addition of bevacizumab did not increase the risk of this kind of adverse events or very serious adverse events and I have also to say that for example pulmonary embolism there was a reduction in the risk of this kind of events. And the explanation behind this observation, for me at least, is that maybe the combination of the drugs achieved a better response to the treatment, so the risk related to the disease to give thrombosis and then embolism was reduced.

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