Cervical cancer patients categorized as mid- or high-risk using the Moore criteria can benefit from adding bevacizumab to their chemotherapy regimen, according to a new study published in Clinical Cancer Research.
The Moore criteria, which were developed in 2010 by David H. Moore, MD, former chair of the Gynecologic Oncology Group Cervix Cancer Committee, include five clinical factors that have been proposed as indicators of poor outcomes among patients with advanced cervical cancer. Those five factors include: African-American descent, a performance status of 1, pelvic disease, prior platinum-based treatment, and progression-free survival of less than 1 year. Patients are then categorized according to the presence of these factors as low-risk (0–1 factors), mid-risk (2–3 factors), or high-risk (4–5 factors).
Researchers used the Moore criteria to assess the risk levels of 452 patients with advanced cervical cancer. When treatment consisted of chemotherapy without bevacizumab, median overall survival was 21.8 months for low risk-patients, 14.7 months for mid-risk patients, and 8.2 months for high-risk patients.
For low-risk patients, there was no significant difference in median overall survival for patients assigned only chemotherapy (21.8 months) versus those assigned chemotherapy and bevacizumab (22.9 months). However, for high-risk and mid-risk patients, adding bevacizumab to treatment was associated with significantly longer median overall survival (17.9 months vs 12.1 months and 12.1 months vs 6.3 months, respectively)
The researchers concluded that the Moore criteria is a clinically relevant tool for assessing risk in cervical cancer patients, and that the benefits of adding bevacizumab appear to increase with risk of poorer outcomes. However, they caution that toxicity concerns with bevacizumab may justify omitting the drug in low-risk patients for whom the survival benefit is small.
