Randomized trial of cisplatin versus cisplatin plus mitolactol versus cisplatin plus ifosfamide in advanced squamous carcinoma of the cervix: a Gynecologic Oncology Group study.

Abstract

CIFX improved the response rate and PFS duration in advanced cervix cancer compared with cisplatin alone, but at the cost of greater toxicity and with no improvement in survival.

Phase I–II study of irinotecan (CPT-11) plus nedaplatin (254-S) with recombinant human granulocyte colony-stimulating factor support in patients with advanced or recurrent cervical cancer

“…A randomised study performed by the GOG in 438 assessable patients indicated that the combination of cisplatin and ifosfamide achieved a higher response rate and a longer progression-free survival time compared with cisplatin alone. However, the combination was more toxic and there was no difference of overall survival (Omura et al, 1997), suggesting the need to develop new combinations for advanced or recurrent cervical cancer. In this study, the overall response rate was 59%, while among the 12 responders with recurrent disease, the median time to progression and median survival time were 161 days (range: 61 -711 days) and 415 days (range: 74 -801 days), respectively.…”

Immunotherapy: An Evolving Paradigm in the Treatment of Advanced Cervical Cancer

“…3,4 Since the publication of the initial studies examining cisplatin in the treatment of cervical cancer, a number of effective single-agent and combination drug regimens have been identified that exhibited improved response rates, without a significant effect on overall survival. [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] The poor oncologic outcome in this patient population represents an unmet clinical need and has driven the exploration of new treatment paradigms. 3 Most recently, the results of Gynecologic Oncology Group (GOG) protocol 240 were presented and Scan the QR Code with your phone to obtain FREE ACCESS to the articles featured in the Clinical Therapeutics topical updates or text GS2C65 to 64842.…”

PRO: Patients With Metastatic/Recurrent Cervical Cancer Should Be Treated With Cisplatin Plus Paclitaxel

“…Further testament to this hypothesis is the observation that in this study, the RR and PFS for the single-agent cisplatin arm were lower than that observed in previous trials. 17,18,20 Although the 4-arm study reported by Monk et al (described above) was designed while the cisplatin/topotecan study was ongoing, the combination of cisplatin plus paclitaxel was selected as the reference arm primarily because of its relatively high RR as reported by Moore et al 20,24 It was also deemed important to determine whether the activity of cisplatin plus paclitaxel would be sustained in the era of chemoradiation for locally advanced disease.…”

“…16 The next 2 trials evaluated the addition of ifosfamide, bleomycin, and mitolactol to cisplatin-based therapies. 17,18 Among some of the lessons learned during the 1980s and 1990s governing chemotherapy for recurrent cervical cancer were that platinum-based therapies were most effective, and that cisplatin was more active than carboplatin (response rates [RRs], 19% vs. 15%, respectively). 19 Two ways through which the RR could be increased without prolongation in survival included increasing the platinum dose and/or adding ifosfamide to cisplatin.…”