According to results presented at the 2004 annual meeting of the American Society of Gynecologic Oncologists, the chemotherapy combination consisting of cisplatin and topotecan improves survival compared to cisplatin alone in patients with recurrent or advanced cervical cancer.
The cervix is a glandular organ that is located at the bottom of the uterus. Due to screening methods for cervical cancer practiced routinely in the United States, cervical cancer is often diagnosed in early stages, prior to the spread of cancer, and cure rates remain high. However, some patients are diagnosed with advanced cervical cancer, where the cancer has spread to several and/or distant sites in the body, or experience a cancer recurrence following initial therapy. Patients with advance or recurrent cervical cancer may be treated with surgery to remove cancer, chemotherapy and/or radiation therapy.
Researchers affiliated with the Gynecologic Oncology Group (GOG) recently conducted a clinical trial to directly compare the chemotherapy combination consisting of cisplatin (Platinol®) and topotecan (Hycamtin®) to cisplatin alone in the treatment of advanced or recurrent cervical cancer. This trial included 293 patients, 80% of whom had recurrent cancer following previous therapy. A third group of patients in this trial were treated with the chemotherapy combination consisting of methotrexate, vinblastine, doxorubicin and cisplatin (MVAC); however, this regimen was discontinued early in the trial due to unacceptable side effects. Overall anti-cancer responses were 27% for patients treated with cisplatin/topotecan, compared with only 13% for those treated with cisplatin alone. Progression-free survival was 4.6 months for patients treated with cisplatin/topotecan, compared with only 2.9 months for those treated with cisplatin alone. Overall survival was 9.4 months for patients treated with cisplatin/topotecan, compared with only 6.5 months for those treated with cisplatin alone.
The researchers concluded that the combination of cisplatin/topotecan improves survival compared with cisplatin alone in patients with advanced or recurrent cervical cancer. This is the first chemotherapy combination that has demonstrated an improvement in survival over cisplatin alone in the treatment of this disease, and will be used as the treatment regimen to which other chemotherapy regimens will be compared in an upcoming clinical trial conducted by affiliates of GOG for recurrent or advanced cervical cancer. Patients with advanced or recurrent cervical cancer may wish to speak with their physician about the risks and benefits of treatment with cisplatin/topotecan or the participation in a clinical trial evaluating other novel therapeutic approaches.
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Reference: Monk B, Huang H, Wenzel L, et al. Quality of Life Outcomes From a Phase III Trial of Cisplatin Versus Cisplatin Plus Topotecan in Stage IVB, Recurrent or Persistent Carcinoma of The Cervix: Results of GOG Protocol 179. Proceedings from the 35th annual meeting of the American Society of Gynecologic Oncologists. February 2004.