Background: 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.
Objective: 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.
Methods: 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 Results were compared to the GOG-240 trial as a historical reference.
Results: 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.
Conclusion: 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.
