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Real-world Efficacy Data on Anti-Angiogenic Drugs in Recurrent Small Cell Cervical Carcinoma: A Retrospective Study
Haifeng Qiu1, Ning Su2, Shuping Yan3
1Department of Gynecology, 191599The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Objective:
Small cell carcinoma of the cervix (SCCC) is rare but extremely aggressive and resistant to current therapies. We herein evaluate the efficacy of bevacizumab, apatinib, and anlotinib in recurrent/metastatic SCCC patients in a real-world setting.
Methods:
Recurrent/metastatic SCCC patients were recruited between January 2013 and July 2020. Baseline characteristics were extracted from medical records, and patients were divided into an anti-angiogenic group and non-anti-angiogenic group. The efficacy of treatments was determined using Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 criteria. Kaplan-Meier analysis was performed for survival analysis.
Results:
Sixteen patients received anti-angiogenic drugs after tumor recurrence/metastasis; of them, 10 cases received them as first-line treatment, 5 cases as second-line treatment, and 1 case as fourth-line treatment. Another 23 patients received traditional therapies, including surgery, chemotherapy, and radiotherapy. The use of anti-angiogenic drugs in first-line treatment significantly prolonged progression-free survival (PFS) compared to the controls, with a median PFS of 8 months (2-20 months) and 3 months (1-10 months), respectively (P = .025). This trend was also notable in patients who started anti-angiogenic treatment after the second-line recurrence/metastasis. However, there was no benefits for overall survival (OS) in either the 10 first-line cases or all 16 cases (P = .499 and .31, respectively). Both bevacizumab and small molecule drugs (apatinib and anlotinib) presented similar efficacy in SCCC patients.
Conclusions:
At present, this is the largest cohort study that provides real-world data, showing that anti-angiogenic regimens could significantly prolong PFS in recurrent/metastatic SCCC. Aside from bevacizumab, the novel oral small molecule drugs provide more choices with similar efficacy. These findings warrant further validation in well-designed future studies.
Insights
Anti-angiogenic drugs like bevacizumab, apatinib, and anlotinib significantly improve progression-free survival for recurrent small cell cervical cancer (SCCC). While overall survival was not improved, these therapies offer new options for patients with this aggressive disease.
Area of Science:
- Gynecologic Oncology
- Medical Oncology
- Pharmacology
Background:
- Small cell carcinoma of the cervix (SCCC) is a rare and aggressive malignancy.
- SCCC exhibits resistance to conventional therapeutic approaches.
- Limited real-world data exists on novel anti-angiogenic agents for recurrent/metastatic SCCC.
Purpose of the Study:
- To evaluate the real-world efficacy of bevacizumab, apatinib, and anlotinib in patients with recurrent or metastatic SCCC.
- To compare outcomes between anti-angiogenic therapy and traditional treatments in SCCC.
- To assess the impact of these agents on progression-free survival (PFS) and overall survival (OS).
Main Methods:
- Retrospective analysis of recurrent/metastatic SCCC patients (January 2013 - July 2020).
- Patients categorized into anti-angiogenic and non-anti-angiogenic treatment groups.
- Treatment efficacy assessed using RECIST 1.1 criteria; survival analyzed with Kaplan-Meier methods.
Main Results:
- Anti-angiogenic therapy, particularly in first-line treatment, significantly prolonged PFS (median 8 months vs. 3 months, P=.025).
- A similar trend of prolonged PFS was observed for later-line anti-angiogenic treatments.
- No significant improvement in overall survival (OS) was noted for either first-line or all patients receiving anti-angiogenic agents.
Conclusions:
- Anti-angiogenic regimens represent a viable therapeutic option, significantly extending PFS in recurrent/metastatic SCCC.
- Novel oral small molecule drugs (apatinib, anlotinib) offer comparable efficacy to bevacizumab, expanding treatment choices.
- Further prospective studies are warranted to validate these real-world findings and optimize treatment strategies.
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