Induction Chemotherapy With Gemcitabine and Oxaliplatin for Locally Advanced Cervical Carcinoma

Abstract

Induction chemotherapy followed by surgery, particularly with newer agents or combinations, remains to be explored in locally advanced cervical cancer. Gemcitabine cisplatin is a very active combination for this tumor, therefore we explored the activity of gemcitabine in combination with oxaliplatin. Ten untreated patients with histologic diagnosis of cervical carcinoma and staged as IB2 to IIIB were treated with 3 21-day courses of oxaliplatin 130 mg/m day 1 and gemcitabine 1,250 mg/m days 1 and 8 followed by locoregional treatment with either surgery or concomitant chemoradiation. Response and toxicity were evaluated at the end of chemotherapy. All patients were evaluable. The overall clinical response rate was 80%, being complete in 3 patients (30%) and partial in 5 (50%). Seven (70%) patients underwent surgery, and three (30%) had chemoradiation as definitive treatment. Hematologic toxicity was moderate, with leukopenia grades III-IV in 17 and 0%; granulocytopenia grades III-IV in 23 and 3%, respectively. Eight patients had grade I oropharyngeal toxicity. At a median follow-up of 11 months (range: 10-12), all patients are disease free. Gemcitabine oxaliplatin is a very active and well-tolerated combination for locally advanced cervical cancer.

Weekly cisplatin or gemcitabine concomitant with radiation in the management of locally advanced carcinoma cervix: results from an observational study

“…3 Gemcitabine has been used in cervical cancers with good results both as a single agent and in combination with cisplatin concurrent with radiotherapy. [4][5][6][7][8][9][10][11][12][13][14] The aim of present study was to evaluate the toxicity and efficacy of concurrent weekly Gemcitabine against the widely accepted concurrent weekly cisplatin with standard convention radiotherapy in management of locally advanced cervical cancer.…”

Pre-exenterative chemotherapy, a novel therapeutic approach for patients with persistent or recurrent cervical cancer

“…So far there is information of the efficacy of chemotherapy in terms of pathological response in recurrent or advanced cervical cancer because chemotherapy is only used as a palliative measure and surgery is commonly not affered after chemotherapy. Here we demonstrate a pathological complete response rate of 44% in the nine patients treated (23.5% taking into the 17 patients), which is higher than obtained in neoadjuvant trials in locally advanced cervical cancer utilizing platinum-based schemes with newer drugs, such as gemcitabine [ 32 , 33 ], vinorelbine [ 34 ], paclitaxel [ 35 , 36 ], and irinotecan [ 37 ]. It is worthwhile noticing that the neoadjuvant trials with lower complete response rates were those that subjected more patients to surgery.…”

Multicenter Phase II Study of Gemcitabine and Oxaliplatin (GEMOX) as Second-Line Chemotherapy in Colorectal Cancer Patients Pretreated with 5-Fluorouracil plus Irinotecan

“…The gemcitabine plus oxaliplatin combination has been tested in various advanced solid tumors with a moderate or marginal activity [42,43,44,45,46,47,48,49,50,51,52]. However, in all these studies a common characteristic was the favorable toxicity profile and tolerability of the XEMOX combination since only mild-to-moderate myelosuppression and peripheral neurotoxicity were observed.…”