Bevacizumab eligibility in patients with metastatic cervical cancer: A retrospective review.

e17021 Background: Bevacizumab (BEV) is approved for use in combination with chemotherapy for metastatic/recurrent cervical cancer (CC) based on the GOG 240 trial, which showed increased survival and response rates (RR). However, because of its contraindications, use of BEV is not always feasible or safe. The purpose of this study was to identify the percentage of metastatic/recurrent CC patients at our institution who would have been eligible to receive BEV according to eligibility criteria from GOG 240. Methods: A retrospective study was conducted to identify metastatic CC patients treated at UFHealth between 2006-2016. Chart review was performed to determine their kidney, liver, and bone marrow function, ECOG performance status (PS), presence of an active bleeding condition or nonhealing wound, or inadequately treated venous thromboembolism. Data analysis was performed to determine if the patient would have been eligible to receive BEV based on eligibility criteria from GOG 240. Results: We identified 62 patients with metastatic CC treated at UFHealth between 2006-2016: 1 patient was excluded due to insufficient data. 55 patients (90.2%) would have been ineligible to receive BEV based on the GOG 240 exclusion criteria, and 6 patients (9.8%) would have been eligible. The most common reason for exclusion from BEV use was active bleeding (45 of 61 pts: 73.8%); 42 of the 45 with bleeding (93.3%) had vaginal bleeding. 18 of 61 (29.5%) would be excluded due to poor PS, 17 of 61 (27.9%) due to poor renal function, and 13 of 61 (21.3%) due to an inadequately anticoagulated thromboembolism. Conclusions: Despite the improved survival and higher RR associated with BEV use in combination with chemotherapy, only 9.8% of metastatic CC patients treated at UFHealth over a ten year period would have been eligible to receive BEV. Most patients would have been excluded due to active bleeding, most commonly vaginal bleeding. Though clinical trial data supports the use of BEV with chemo, many patients are simply not eligible due to complications from their disease. Identifying novel therapies for metastatic/recurrent CC patients with improved safety profiles that would allow for their use in this challenging population is critical.