High expression of vascular endothelial growth factor is a risk factor for poor response to neoadjuvant Paclitaxel -...

Cervical cancer ranks among the top causes of death worldwide in gynecological cancers and is among the most prevalent cancers worldwide, particularly in Indonesia. This study aims to prove that high expression of Vascular Endothelial Growth Factor (VEGF) is a risk factor for a poor response to neoadjuvant paclitaxel-carboplatin chemotherapy in cervical cancer stages IB3, IIA2, and IIB.

This nested case-control study was conducted in Prof. I G.N.G. Ngoerah General Hospital, Denpasar. All medical data were collected from October 2022 to April 2023. The case group consisted of 28 patients with cervical cancer stages IB3, IIA2, and IIB who showed a poor response to three cycles of neoadjuvant paclitaxelcarboplatin chemotherapy, while the control group consisted of 28 patients who had a good response to the same treatment. The variables were the expression of VEGF protein, response to neoadjuvant chemotherapy, and baseline characteristics (primary tumor size, histopathological grading, histopathological type, age, parity, and BMI). Data analysis was performed descriptively and analytically using Chi-square tests and logistic regression.

There was no significant differences in age, parity, BMI, primary tumor size, degree of differentiation, and histopathological type between the case and control groups. High VEGF expression was found in 78.5% of the case group and 25% of the control group. Further analysis showed that high VEGF expression was significantly associated with a poor chemotherapy response, with an odds ratio (OR) of 16.97 (95% CI 3.17 - 38.15, p = 0.001).

High VEGF expression is a significant risk factor for a poor response to neoadjuvant paclitaxelcarboplatin chemotherapy in cervical cancer stages IB3, IIA2, and IIB.