Cediranib Aims for a Comeback

extract JNCI

Women with advanced ovarian or cervical cancer are living longer, with fewer disease symptoms, and that reflects advances across clinical and supportive therapies. 

Bevacizumab, for instance—a recently approved monoclonal antibody that targets vascular endothelial growth factor (VEGF)—improves overall survival (OS) and progression-free survival (PFS) in both diseases. In August 2014, the U.S. Food and Drug Administration approved bevacizumab in combination with chemotherapy to treat platinum-resistant recurrent ovarian cancer. And the following November, FDA approved the drug to treat persistent, recurrent, or metastatic cervical cancer, also with chemotherapy. Those were the first new approvals in ovarian and cervical cancer treatment since 2006.

Interest Revived

Now a different VEGF-directed compound, cediranib, a tyrosine kinase inhibitor, is making steady gains in ovarian and cervical cancer treatment. Cediranib’s manufacturer, AstraZeneca, abandoned its own sponsored development of the drug in 2011 after it failed to meet phase III goals in lung and colorectal cancers. But investigator-initiated studies in gynecological cancers gave cediranib another chance. These studies show improved OS and PFS, but also with side effects that seem worse than those associated with bevacizumab, according to David Hyman, M.D., a gynecological medical oncologist and assistant professor at New York’s Memorial Sloan–Kettering Cancer Center.

“We don’t really know if bevacizumab and cediranib are interchangeable,” he said. “We still need to define the approval setting …

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