Combination therapy with irinotecan and cisplatin as neoadjuvant chemotherapy in locally advanced cervical cancer

Abstract

) given intravenously on day 1. Treatment was repeated every 4 weeks for a total of two or three cycles. Among 23 eligible patients (median age: 59 years), three showed complete response (13%), 15 showed partial response (65%), for an overall response rate of 78% (95% confidence interval 58-90%). Stable disease was observed in four cases (17%) and progressive disease in one (4%). The median time to failure and median survival time have not yet been reached. Of the 52 treatment cycles administered, diarrhoea and grade 3 or 4 neutropenia were observed in 10% and 75% respectively. There were no therapy-related deaths. The combination of CPT-11 with cisplatin is a promising regimen for neoadjuvant chemotherapy in locally advanced cervical cancer. The toxicities of this regimen are well tolerated.

Neoadjuvant Chemotherapy Using Platinum-Based Regimens for Stage Ib2-II Squamous Cell Carcinoma and Non-Squamous Cell Carcinoma of the Cervix

“…Table 5 shows the results of the present study in comparison to those of previous reports (Sugiyama et al, 1999;Hwang et al, 2001;Dueñas-Gonzalez et al, 2001;D'Agostino et al, 2002;Di Vagno et al, 2003;Dueñas-Gonzalez et al, 2003;Umesaki et al, 2004; and this study. Table 5.…”

“…This analysis suggested the effectiveness of NAC, if: one cycle of treatment lasted no more than 14 days; and the DI of CDDP exceeded 25 mg/m 2 /week (Neoadjuvant Chemotherapy for Cervical Cancer Metaanalysis Collaboration., 2003). Sugiyama et al reported a CDDP/CPT-11 therapy schedule involving CPT-11 doses on Days 1, 8, and 15 (one course = 28 days) (Sugiyama et al, 1999). We evaluated the efficacy and safety of CDDP/CPT-11 therapy, reportedly an effective NAC regimen, using modified doses and administration schedules.…”

“…In Western countries, concurrent chemoradiation (CCRT) has been recommended as a standard therapy for such tumors based on the results of multiple large-scale randomized trials and meta-analyses (Morris et al, 1999;Rose et al, 1999;Whitney et al, 1999;Pearcey et al, 2002;Eifel et al 2004;Green et al 2001;Lukka et al, 2002). In Japan, Korea, Italy and some other countries, the neoadjuvant chemotherapy (NAC) approach has been extensively introduced to clinical practice (Sugiyama et al, 1999). NAC is considered to be clinically significant in 2 respects: it is expected to improve the radicality and safety of surgery by reducing tumor size; and it is expected to exert systemic effects, i.e., effects on lymph node occult micrometastases, etc.…”

Phase I study of combination chemotherapy with irinotecan hydrochloride and nedaplatin for cervical squamous cell carcinoma: Japanese gynecologic oncology group study

“…Sugiyama et al (5,6) reported that patients with cervical carcinoma treated with CPT-11 (60 mg/m 2 ) on days 1, 8 and 15 and CDDP (60 mg/m 2 ) on day 1 showed response rates of 59% for advanced/recurrent carcinoma and 78% in NAC for locally advanced cervical carcinoma. In their study, however, treatment with CPT-11 on days 8 and 15 had to be skipped in a high percentage (31%) of patients.…”

“…In a late phase II study in patients with cervical carcinoma, it exhibited relatively high efficacy, with a response rate of 23% (4). Sugiyama et al (5) reported that administration of CPT-11 (60 mg/m 2 ) on days 1, 8 and 15 with CDDP (60 mg/m 2 ) on day 1 yielded a response rate of 59% in cases of advanced or recurrent cervical cancer and 78% in cases in which this regimen was applied as a neoadjuvant chemotherapy for advanced cervical carcinoma (6).…”