# Real-world evaluation of bevacizumab plus platinum and paclitaxel for advanced cervical cancer: a single-arm study from Syria

## TL;DR

This study shows that bevacizumab combined with chemotherapy is effective for advanced cervical cancer in Syria, with better outcomes than a major international trial.

## Contribution

The study provides real-world evidence from Syria, a low-resource setting, supporting the use of bevacizumab-based therapy for cervical cancer.

## Key findings

- Median progression-free survival was 10.1 months, a 23.2% improvement over the GOG-240 trial.
- Restricted mean survival time showed a 25.7% survival benefit at 12 months.
- Objective response rate was 61.3%, higher than the 48% reported in the reference trial.

## Abstract

Bevacizumab combined with chemotherapy has become a standard first-line treatment for advanced cervical cancer following the Gynecologic Oncology Group (GOG)-240 trial. However, real-world data from low-resource settings, such as Syria, remain limited.

To evaluate the clinical effectiveness of bevacizumab with paclitaxel and either cisplatin or carboplatin in Syrian patients with metastatic or recurrent cervical cancer, using both median progression-free survival (PFS) and restricted mean survival time (RMST) analysis.

A single-arm prospective/retrospective study was conducted at Al-Beiruni University Hospital between January 2023 and December 2024, including 64 patients. Treatment was administered every 21 days with a median of eight cycles per patient (range: 4–20). PFS was estimated using Kaplan–Meier analysis, while RMST was calculated at 3, 6, 9 and 12 months using MedCalc and Python-based tools. Results were compared to the GOG-240 trial as a historical reference.

The median PFS was 10.1 months (95% CI: 9.46–10.75), representing a 23.2% increase over GOG-240. RMST analysis demonstrated a consistent survival benefit, with a 25.7% gain at 12 months. The objective response rate reached 61.3%, compared to 48% in the reference trial.

This study supports the effectiveness of bevacizumab-based therapy as a first-line option in the Syrian setting, showing sustained clinical benefit and reinforcing the relevance of international guidelines in local oncology practice.