GOG 240 Trial: Bevacizumab for advanced cervical cancer: final overall survival and adverse event analysis of a randomised, controlled, open-label, phase 3 trial.

Type: Cervical Cancer

Section: Medical treatment for cervical cancer

Published: October 2024

The goal of the trial was to see if adding bevacizumab would improve survival and slow the progression of the cancer.
Background
Cervical cancer, especially when it spreads beyond the cervix, can be difficult to treat. For advanced or recurrent cervical cancer (cancer that comes back after treatment), the options are often limited. Chemotherapy has been the primary treatment, but doctors have been searching for ways to improve outcomes for these patients. The GOG240 trial was designed to see if adding bevacizumab to the standard chemotherapy treatment would help women with advanced or recurrent cervical cancer live longer.

What is Bevacizumab?
Bevacizumab is a type of targeted cancer drug treatment. It is also known as Avastin. It works by stopping cancer cells from making new blood vessels, so it is starved and can’t grow. This type of treatment is called anti-angiogenic therapy. The GOG240 trial was done to find out if adding bevacizumab to standard chemotherapy could help women with advanced or returning cervical cancer live longer.

Schematic Illustration of the mechanism of bevacizumab


The GOG240 Trial
The GOG240 trial, launched in 2009, involved 452 women with either advanced cervical cancer or cancer that had returned after initial treatment. These women were divided into two groups. One group received the standard chemotherapy treatment, while the other group received chemotherapy along with bevacizumab.
The goal of the trial was to see if adding bevacizumab would improve survival and slow the progression of the cancer.

Outcome
The results of the GOG240 trial, published in 2014, showed that adding bevacizumab to chemotherapy significantly improved outcomes for women with advanced or recurrent cervical cancer. Here are the key results:
• Improved Survival: Women who received bevacizumab along with chemotherapy lived nearly 4 months longer on average compared to those who had chemotherapy alone. The median survival was 17 months for the bevacizumab group, compared to 13.3 months for those who only had chemotherapy.

• Higher Response Rates: More women in the bevacizumab group saw their cancer shrink or stop growing for a period of time compared to those in the chemotherapy-only group.
These results were significant because they showed that adding bevacizumab could help women live longer, even when their cancer was advanced or had returned.

Conclusion
The GOG240 trial was a major step forward in the treatment of advanced or recurrent cervical cancer. It showed that adding bevacizumab to standard chemotherapy can significantly extend survival for women with these challenging cases of cervical cancer. As a result of this trial, bevacizumab is now commonly used in combination with chemotherapy for women with advanced or recurrent cervical cancer.
This trial highlights how ongoing research and clinical trials can lead to important breakthroughs, improving the chances of survival and quality of life for patients facing difficult-to-treat cancers.

References:
1. Tewari, K. S., Sill, M. W., Long, H. J., 3rd, Penson, R. T., Huang, H., Ramondetta, L. M., Landrum, L. M., Oaknin, A., Reid, T. J., Leitao, M. M., Michael, H. E., & Monk, B. J. (2014). Improved survival with bevacizumab in advanced cervical cancer. The New England journal of medicine, 370(8), 734–743. https://doi.org/10.1056/NEJMoa1309748

2. Tewari, K. S., Sill, M. W., Penson, R. T., Huang, H., Ramondetta, L. M., Landrum, L. M., Oaknin, A., Reid, T. J., Leitao, M. M., Michael, H. E., DiSaia, P. J., Copeland, L. J., Creasman, W. T., Stehman, F. B., Brady, M. F., Burger, R. A., Thigpen, J. T., Birrer, M. J., Waggoner, S. E., Moore, D. H., … Monk, B. J. (2017). Bevacizumab for advanced cervical cancer: final overall survival and adverse event analysis of a randomised, controlled, open-label, phase 3 trial (Gynecologic Oncology Group 240). Lancet (London, England), 390(10103), 1654–1663. https://doi.org/10.1016/S0140-6736(17)31607-0

3. S.K. Mukherji. American Journal of Neuroradiology February 2010, 31 (2) 235-236; DOI: https://doi.org/10.3174/ajnr.A1987