A PHASE-II STUDY OF IFOSFAMIDE, CARBOPLATIN AND CISPLATIN IN ADVANCED AND RECURRENT SQUAMOUS-CELL CARCINOMA OF THE UTERINE CERVIX

Background: Discouraging response durations and long-time survivals have so far been the result of cisplatin-containing combination chemotherapy against advanced or recurrent squamous cell carcinoma of the uterine cervix. In order to increase the platinum-based effect upon this tumor without an increase in the specific toxicity of cisplatin, we combined it with carboplatin, added ifosfamide, which has been shown to possess a comparable degree Of Single-agent activity. Patients and Methods: Thirty-six patients with advanced or recurrent squamous cell carcinoma of the uterine cervix not curable by radiation or surgery were treated with a combination of ifosfamide 1.5 gr/m2 i.v. days 1-3, carboplatin 200 mg/m2 i.v. day 1, and cisplatin 50 mg/m2. Thirty-one patients were evaluable for response and 34 patients for toxicity. Results: Twenty-three patients responded (64%), 11 (31%) of them completely, and 12 (33%) partially. Median response duration was 23 weeks (range 8-107 weeks), reaching 27 weeks and 21 weeks for patients with and without disease in previously irradiated areas, respectively. Median survival is 40 weeks (range 1-114 weeks). Toxicity consisted mainly of moderate to severe myelosuppression, resulting in 2 toxic deaths. Conclusion: The response rate, also for earlier irradiated areas, compares favorably with other known cisplatin-containing regimens. The combination deserves investigation in a randomized setting.