RT Journal Article
SR Electronic
T1 #997 Therapeutic paradigm: notable efficacy of pemetrexed in managing recurrent cervical cancer after a year gap of treatment – case report
JF International Journal of Gynecologic Cancer
JO Int J Gynecol Cancer
FD BMJ Publishing Group Ltd
SP A104
OP A104
DO 10.1136/ijgc-2023-ESGO.212
VO 33
IS Suppl 3
A1 Sharashenidze, Archil
A1 Kochiashvili, Gvantsa
A1 Khubua, Irine
A1 Jobava, Irine
A1 Khoperia, Ana
A1 Aslanishvili, Beka
A1 Jokharidze, Tedo
A1 Mezvrishvili, Manana
A1 Sharashenidze, Nino
YR 2023
UL http://ijgc.bmj.com/content/33/Suppl_3/A104.2.abstract
AB Introduction/Background Managing patients with recurrent cervical cancer presents a substantial challenge. This case report about pemetrexed showing effectiveness in a patient with recurrent cervical cancer and a year gap in treatment due to financial constraints highlights the need for personalisation of treatment approaches.Methodology In 2019, a 52-year-old woman was diagnosed with cervical squamous cell cancer (spindle-cell type) classified as cT4N1M0. The tumor measured 67*55*51 mm and exhibited infiltrative growth in the myometrium, parametria, and all layers of the posterior urinary bladder wall (confirmed mucous layer involvement through cystoscopy). Additionally, there were metastatic lesions in the iliac lymph nodes. CT scans of the chest and abdomen did not reveal any pathology related to the primary tumor. Initial chemoradiotherapy with paclitaxel and cisplatin resulted in disease stabilization by May 2020. However, a recurrence was observed in the clitoris, mediastinal lymph nodes, and liver one year later. The patient received additional cycles of Paclitaxel+Cisplatin and external beam radiation therapy (EBRT). Towards the end of 2021, disease progression was evident with new lesions in the lungs and inguinal lymph nodes (LNs). In early 2022, three cycles of pemetrexed were initiated, resulting in a significant reduction in the size of existing lesions and disappearance of some lung lesions. This was followed by three more cycles of pemetrexed in April and May 2022, leading to stabilization by June. However, the patient was unable to continue treatment beyond that point due to financial constraints.Results Six months later, radiologic evaluation revealed disease progression, prompting the multidisciplinary team to initiate treatment with pemetrexed. As of the most recent update, the patient has achieved stabilization.Conclusion Pemetrexed demonstrated effectiveness in managing recurrent cervical cancer in our patient despite a one-year gap in the course of the treatment. Further research is warranted to optimize the use of pemetrexed.Disclosures No conflicts of interest or financial disclosures to report.