Bevacizumab is increasingly used in recurrent, persistent or metastatic cervical cancer. The early retrospective case reports found that bevacizumab combined with 5-FU (including capecitabine) or paclitaxel was well tolerated and displayed encouraging anti-tumor activity in recurrent or persistent cervical cancer. Phase Ⅱ clinical trials showed that bevacizumab was well tolerated and active in the second- and third-line treatment of patients with recurrent cervical cancer. Large scale phase Ⅱ and phase Ⅲ clinical trials demonstrated that bevacizumab-containing chemotherapy was effective in the first- and second-line treatment of patients with persistent cervical cancer, prolonged survival time and improved remission rate. The article also reviews the research progress on predictive factors of bevacizumab efficacy, showing the use of imaging and biomarkers in predicting the efficacy of bevacizumab treatment. In addition, this article analyzes the cost-effectiveness of bevacizumab, finding that bevacizumab combined with chemotherapy meets the standard of cost-effectiveness.
贝伐珠单克隆抗体（单抗）在复发性、难治性或转移性子宫颈癌中的应用逐渐增多。最早的回顾性病例报告中报道了贝伐珠单抗联合氟尿嘧啶（包括卡培他滨）或者紫杉醇对复发性或难治性子宫颈癌有一定的疗效并且药物耐受性良好。之后的Ⅱ期临床研究发现，贝伐珠单抗单剂治疗复发性宫颈鳞癌作为二线或三线治疗药物有效，耐受性良好。大型Ⅱ期和Ⅲ期临床研究进一步证实贝伐珠单抗联合化疗方案在一线、二线治疗难治性子宫颈癌可延长患者的生存期，提高患者的缓解率。此外，一部分患者对贝伐珠单抗治疗无反应或在治疗过程中会逐渐耐药，影像学检查结果和生物学标志物等可预测贝伐珠单抗的疗效。贝伐珠单抗联合化疗方案达到了常见的成本效益标准。