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  • A Phase 2 Multicenter Study of Irinotecan and Cisplatinum as Neoadjuvant Treatment in Patients With Locally Advanced Cervical Cancer

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Cervical Cancer
A Phase 2 Multicenter Study of Irinotecan and Cisplatinum as Neoadjuvant Treatment in Patients With Locally Advanced Cervical Cancer
  1. Francesco Raspagliesi, MD*,
  2. Antonino Ditto, MD*,
  3. Luigi Selvaggi, MD†,
  4. Luigi Frigerio, MD‡,
  5. Mauro Melpignano, MD§,
  6. Giovanni Scambia, MD∥,
  7. Chiara Apolloni, MD,
  8. Paolo Scollo, MD**,
  9. Sandro Pignata, MD†,‡ and
  10. Pierluigi Benedetti Panici, MD†,‡
  1. * Gynecologic Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan;
  2. † II Department of Obstetric and Gynecology, Bari University, Bari;
  3. ‡ Obstetric and Gynecology, Riuniti Hospital, Bergamo;
  4. § Obstetric and Gynecology, Hospital of Parma, Parma;
  5. ∥ Obstetric and Gynecology, Policlinico Gemelli University, Rome;
  6. Obstetric and Gynecology, Insubria University, Varese;
  7. ** Obstetric and Gynecology, Cannizzaro Hospital, Catania;
  8. †† Gynecologic Oncology Unit, Pascale Istituto Nazionale dei Tumori, Naples; and
  9. ‡‡ Obstetric and Gynecology, La Sapienza University, Rome, Italy.
  1. Address correspondence and reprint requests to Francesco Raspagliesi, MD, Fondazione IRCCS Istituto Nazionale Tumori, via Venezian 1, 20133 Milan, Italy. E-mail: Raspagliesi{at}istitutotumori.mi.it.

Abstract

Hypothesis: To evaluate efficacy and safety of a neoadjuvant treatment with irinotecan and cisplatin [cis-diamminedichloroplatinum(II); CDDP] in patients with locally advanced cervical cancer.

Methods: A phase 2 study was conducted at 13 centers located in Italy. Eighty-seven were enrolled between 2000 and 2003. Patients received irinotecan 175 mg/m2 on day 1 every 3 weeks followed by CDDP 80 mg/m2. Each patient was to receive 3 cycles of treatment. Tumor response was to be evaluated by magnetic resonance imaging 3 weeks after the end of the third cycle. At the end of therapy, all patients were to be examined for radical surgery.

Results: Of 71 patients included in the primary analysis, 9 (12.7%) showed a complete response; and 43 (60.6%), a partial response for an overall response rate of 73.2% (95% confidence interval [CI], 61.4%-83.1%). Complete pathological responses were observed in 13.6% of the patients (95% CI, 7.0%-23.0%). Overall survival rate at 4 years was 87.0% (95% CI, 79.5%-94.5%).

There were no study-related deaths. Most common adverse events were alopecia in 76 patients (87.4%) and gastrointestinal disorders in 79 patients (90.8%). Serious adverse events were vomiting in 18 patients (20.7%), nausea in 14 (16.1%), diarrhea in 8 (9.2%), and neutropenia in 50 (57.5%). A total of 3 patients (3.4%) were discontinued from the study owing to the occurrence of 1 or more serious adverse event.

Conclusions: Irinotecan and CDDP as neoadjuvant chemotherapy in locally advanced cervical cancer showed a promising response rate. These data warrant confirmation with a phase 3 study.

  • Locally advanced cervical cancer
  • Neoadjuvant chemotherapy
  • Camptothecin-11
  • Phase 2 study
  • Radical surgery

https://doi.org/10.1111/IGC.0b013e3181cc71f7

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