Neoadjuvant chemotherapy with cisplatin, ifosfamide and paclitaxel for locally advanced squamous-cell cervical cancer

G. Zanetta, A. Lissoni, A. Pellegrino, C. Sessa, N. Colombo, D. Gueli-Alletti, C. Mangioni

Research output: Contribution to journalArticle

71 Citations (Scopus)

Abstract

Background: Neoadjuvant chemotherapy is increasingly being used for the treatment of bulky and locally-advanced cervical cancer. Cisplatin and ifosfamide are known to be effective in cervical cancer, while paclitaxel is one of the promising new drugs for the treatment of this neoplasm. Objective: To assess the toxic effects and antitumor activity of a multidrug neoadjuvant regimen consisting of cisplatin, ifosfamide, and paclitaxel in bulky and locally advanced cervical cancer. Patients and methods: Thirty-eight patients with pathology- confirmed squamous-cell cervical cancer (27 IB2-IIA, two IIB, eight IIIB, one IVA) were prospectively enrolled in the study. Their treatment consisted of paclitaxel 175 mg/m2 given over three hours on day 1, cisplatin 50 mg/m2 (75 mg/m2 in 10 patients), ifosfamide 5 g/m2 in a 24-hour continuous infusion and mesna 5 g/m2 in a 24-hour continuous infusion on day 2, and mesna 3 g/m2 in a 24-hour continuous infusion on day 3. The course was repeated every three weeks for three courses and all of the patients, except those with disease progression or who were inoperable, were scheduled for radical hysterectomy and pelvic lymphadenectomy. Results: All patients are evaluable for response. Eleven achieved clinical complete responses, 21 had partial responses, five had stable disease and one had progression of disease. Of 34 patients who underwent surgery, six (16%) had pathology- documented complete responses, seven (18%) had partial responses with only microscopic residual disease in the cervix, 19 had sub-optimal partial responses, and two had stable disease, for an overall response rate of 84% (95% confidence intervals (CI): 68.7%-94%). Grade 3-4 neutropenia was recorded for 27 (71%) patients, grade 3-4 thrombocytopenia for four (10.5%), and grade 2 peripheral neuropathy for two (2.5%). At a median follow-up of 16 months (range 7-22), 29 (76%) women are alive without recurrence, seven are alive with persistent/recurrent disease and two have died of their disease. Conclusions: According to pathology examination, this regimen yields a 34% complete and optimal partial response rate with acceptable toxicity, and it should be prospectively compared to other regimens.

Original languageEnglish
Pages (from-to)977-980
Number of pages4
JournalAnnals of Oncology
Volume9
Issue number9
DOIs
Publication statusPublished - Sep 1998

Fingerprint

Squamous Cell Neoplasms
Ifosfamide
Uterine Cervical Neoplasms
Drug Therapy
Mesna
Pathology
Paclitaxel
Cisplatin
Disease Progression
Uterine Cervical Diseases
Poisons
Peripheral Nervous System Diseases
TP protocol
Neutropenia
Lymph Node Excision
Hysterectomy
Therapeutics
Confidence Intervals
Recurrence
Pharmaceutical Preparations

Keywords

  • Cervical cancer
  • Neoadjuvant chemotherapy
  • Paclitaxel

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Neoadjuvant chemotherapy with cisplatin, ifosfamide and paclitaxel for locally advanced squamous-cell cervical cancer. / Zanetta, G.; Lissoni, A.; Pellegrino, A.; Sessa, C.; Colombo, N.; Gueli-Alletti, D.; Mangioni, C.

In: Annals of Oncology, Vol. 9, No. 9, 09.1998, p. 977-980.

Research output: Contribution to journalArticle

Zanetta, G. ; Lissoni, A. ; Pellegrino, A. ; Sessa, C. ; Colombo, N. ; Gueli-Alletti, D. ; Mangioni, C. / Neoadjuvant chemotherapy with cisplatin, ifosfamide and paclitaxel for locally advanced squamous-cell cervical cancer. In: Annals of Oncology. 1998 ; Vol. 9, No. 9. pp. 977-980.
@article{5ff33d616ec246da9462c355892d941d,
title = "Neoadjuvant chemotherapy with cisplatin, ifosfamide and paclitaxel for locally advanced squamous-cell cervical cancer",
abstract = "Background: Neoadjuvant chemotherapy is increasingly being used for the treatment of bulky and locally-advanced cervical cancer. Cisplatin and ifosfamide are known to be effective in cervical cancer, while paclitaxel is one of the promising new drugs for the treatment of this neoplasm. Objective: To assess the toxic effects and antitumor activity of a multidrug neoadjuvant regimen consisting of cisplatin, ifosfamide, and paclitaxel in bulky and locally advanced cervical cancer. Patients and methods: Thirty-eight patients with pathology- confirmed squamous-cell cervical cancer (27 IB2-IIA, two IIB, eight IIIB, one IVA) were prospectively enrolled in the study. Their treatment consisted of paclitaxel 175 mg/m2 given over three hours on day 1, cisplatin 50 mg/m2 (75 mg/m2 in 10 patients), ifosfamide 5 g/m2 in a 24-hour continuous infusion and mesna 5 g/m2 in a 24-hour continuous infusion on day 2, and mesna 3 g/m2 in a 24-hour continuous infusion on day 3. The course was repeated every three weeks for three courses and all of the patients, except those with disease progression or who were inoperable, were scheduled for radical hysterectomy and pelvic lymphadenectomy. Results: All patients are evaluable for response. Eleven achieved clinical complete responses, 21 had partial responses, five had stable disease and one had progression of disease. Of 34 patients who underwent surgery, six (16{\%}) had pathology- documented complete responses, seven (18{\%}) had partial responses with only microscopic residual disease in the cervix, 19 had sub-optimal partial responses, and two had stable disease, for an overall response rate of 84{\%} (95{\%} confidence intervals (CI): 68.7{\%}-94{\%}). Grade 3-4 neutropenia was recorded for 27 (71{\%}) patients, grade 3-4 thrombocytopenia for four (10.5{\%}), and grade 2 peripheral neuropathy for two (2.5{\%}). At a median follow-up of 16 months (range 7-22), 29 (76{\%}) women are alive without recurrence, seven are alive with persistent/recurrent disease and two have died of their disease. Conclusions: According to pathology examination, this regimen yields a 34{\%} complete and optimal partial response rate with acceptable toxicity, and it should be prospectively compared to other regimens.",
keywords = "Cervical cancer, Neoadjuvant chemotherapy, Paclitaxel",
author = "G. Zanetta and A. Lissoni and A. Pellegrino and C. Sessa and N. Colombo and D. Gueli-Alletti and C. Mangioni",
year = "1998",
month = "9",
doi = "10.1023/A:1008461408626",
language = "English",
volume = "9",
pages = "977--980",
journal = "Annals of Oncology",
issn = "0923-7534",
publisher = "NLM (Medline)",
number = "9",

}

TY - JOUR

T1 - Neoadjuvant chemotherapy with cisplatin, ifosfamide and paclitaxel for locally advanced squamous-cell cervical cancer

AU - Zanetta, G.

AU - Lissoni, A.

AU - Pellegrino, A.

AU - Sessa, C.

AU - Colombo, N.

AU - Gueli-Alletti, D.

AU - Mangioni, C.

PY - 1998/9

Y1 - 1998/9

N2 - Background: Neoadjuvant chemotherapy is increasingly being used for the treatment of bulky and locally-advanced cervical cancer. Cisplatin and ifosfamide are known to be effective in cervical cancer, while paclitaxel is one of the promising new drugs for the treatment of this neoplasm. Objective: To assess the toxic effects and antitumor activity of a multidrug neoadjuvant regimen consisting of cisplatin, ifosfamide, and paclitaxel in bulky and locally advanced cervical cancer. Patients and methods: Thirty-eight patients with pathology- confirmed squamous-cell cervical cancer (27 IB2-IIA, two IIB, eight IIIB, one IVA) were prospectively enrolled in the study. Their treatment consisted of paclitaxel 175 mg/m2 given over three hours on day 1, cisplatin 50 mg/m2 (75 mg/m2 in 10 patients), ifosfamide 5 g/m2 in a 24-hour continuous infusion and mesna 5 g/m2 in a 24-hour continuous infusion on day 2, and mesna 3 g/m2 in a 24-hour continuous infusion on day 3. The course was repeated every three weeks for three courses and all of the patients, except those with disease progression or who were inoperable, were scheduled for radical hysterectomy and pelvic lymphadenectomy. Results: All patients are evaluable for response. Eleven achieved clinical complete responses, 21 had partial responses, five had stable disease and one had progression of disease. Of 34 patients who underwent surgery, six (16%) had pathology- documented complete responses, seven (18%) had partial responses with only microscopic residual disease in the cervix, 19 had sub-optimal partial responses, and two had stable disease, for an overall response rate of 84% (95% confidence intervals (CI): 68.7%-94%). Grade 3-4 neutropenia was recorded for 27 (71%) patients, grade 3-4 thrombocytopenia for four (10.5%), and grade 2 peripheral neuropathy for two (2.5%). At a median follow-up of 16 months (range 7-22), 29 (76%) women are alive without recurrence, seven are alive with persistent/recurrent disease and two have died of their disease. Conclusions: According to pathology examination, this regimen yields a 34% complete and optimal partial response rate with acceptable toxicity, and it should be prospectively compared to other regimens.

AB - Background: Neoadjuvant chemotherapy is increasingly being used for the treatment of bulky and locally-advanced cervical cancer. Cisplatin and ifosfamide are known to be effective in cervical cancer, while paclitaxel is one of the promising new drugs for the treatment of this neoplasm. Objective: To assess the toxic effects and antitumor activity of a multidrug neoadjuvant regimen consisting of cisplatin, ifosfamide, and paclitaxel in bulky and locally advanced cervical cancer. Patients and methods: Thirty-eight patients with pathology- confirmed squamous-cell cervical cancer (27 IB2-IIA, two IIB, eight IIIB, one IVA) were prospectively enrolled in the study. Their treatment consisted of paclitaxel 175 mg/m2 given over three hours on day 1, cisplatin 50 mg/m2 (75 mg/m2 in 10 patients), ifosfamide 5 g/m2 in a 24-hour continuous infusion and mesna 5 g/m2 in a 24-hour continuous infusion on day 2, and mesna 3 g/m2 in a 24-hour continuous infusion on day 3. The course was repeated every three weeks for three courses and all of the patients, except those with disease progression or who were inoperable, were scheduled for radical hysterectomy and pelvic lymphadenectomy. Results: All patients are evaluable for response. Eleven achieved clinical complete responses, 21 had partial responses, five had stable disease and one had progression of disease. Of 34 patients who underwent surgery, six (16%) had pathology- documented complete responses, seven (18%) had partial responses with only microscopic residual disease in the cervix, 19 had sub-optimal partial responses, and two had stable disease, for an overall response rate of 84% (95% confidence intervals (CI): 68.7%-94%). Grade 3-4 neutropenia was recorded for 27 (71%) patients, grade 3-4 thrombocytopenia for four (10.5%), and grade 2 peripheral neuropathy for two (2.5%). At a median follow-up of 16 months (range 7-22), 29 (76%) women are alive without recurrence, seven are alive with persistent/recurrent disease and two have died of their disease. Conclusions: According to pathology examination, this regimen yields a 34% complete and optimal partial response rate with acceptable toxicity, and it should be prospectively compared to other regimens.

KW - Cervical cancer

KW - Neoadjuvant chemotherapy

KW - Paclitaxel

UR - http://www.scopus.com/inward/record.url?scp=0031793448&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0031793448&partnerID=8YFLogxK

U2 - 10.1023/A:1008461408626

DO - 10.1023/A:1008461408626

M3 - Article

C2 - 9818071

AN - SCOPUS:0031793448

VL - 9

SP - 977

EP - 980

JO - Annals of Oncology

JF - Annals of Oncology

SN - 0923-7534

IS - 9

ER -