The addition of atezolizumab to bevacizumab and chemotherapy in the first-line setting significantly improved progression-free survival (PFS), overall survival (OS), and objective response rate (ORR) among patients with recurrent or metastatic cervical cancer. 

Results from the BEATcc trial were first presented by Ana Oaknin, MD, Vall d’Hebron Institute of Oncology, Barcelona, Spain, at the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer in San Diego, California.

Dr Oaknin and coauthors wrote, “The GOG-240 trial established bevacizumab plus chemotherapy as standard first-line therapy for metastatic (stage IVB), persistent, or recurrent cervical cancer.” In this investigator-initiated trial, the addition of PD-L1 inhibitor, atezolizumab, to the standard of care was evaluated, regardless of PD-L1 status.

In this investigator-initiated, open-label phase 3 trial, 410 patients with measurable recurrent or metastatic cervical cancer who had not previously been treated and were not amenable to curative surgery or radiation were enrolled. Patients were randomized on a 1-to-1 basis to receive the standard therapy of chemotherapy (cisplatin or carboplatin plus paclitaxel and bevacizumab) either alone or with the addition of 1200 mg of atezolizumab on day 1 every 3 weeks. The dual primary end points of this study were investigator-assessed PFS and OS in the intent-to-treat population. Secondary end points included ORR, duration of response (DOR), time to first subsequent therapy (TFST), time to progression on second-line therapy (PFS-2), and safety.

The median follow-up duration at the time of data cutoff was 32.9 months. The median treatment duration in the atezolizumab arm was 12.7 months compared to 8.5 months in the standard arm, with 23% and 7% of patients continuing on treatment, respectively, at the time of data cutoff. The ORR was 84% in the atezolizumab arm compared with 72% in the standard arm. Both PFS and interim OS showed a statistically significant improvement in the atezolizumab arm compared to the standard arm. Safety profiles were as expected with the individual drug profiles, with 79% and 75% of patients experienced a grade ≥3 adverse event in the atezolizumab and standard arms respectively.

Dr Oaknin et al concluded, “Atezolizumab combined with bevacizumab and platinum-based chemotherapy should be considered a new first-line treatment option for patients with [recurrent or metastatic cervical cancer].” 

Source:

Oaknin A, Gladieff L, Martínez-García, et al. BEATcc (ENGOT-CX10/GEICO 68-C/JGOG1084/GOG-3030): A randomized, phase III trial of first-line atezolizumab with bevacizumab and platinum-based chemotherapy for metastatic (stage IVB), persistent, or recurrent cervical cancer. Presented at the Society of Gynecologic Oncology (SGO) Annual Meeting on Women’s Cancer; March 16-18, 2024. San Diego, California.