A phase I–II study of weekly cisplatin and gemcitabine with concurrent radiotherapy in locally advanced cervical carcinoma

Zarbá, Juan José; Jaremtchuk, A.V; Jazey, P. Gonzalez; Keropian, M.; Castagnino, R; Minà, Chiara; Arroyo, G.

doi:10.1093/annonc/mdg345

Cited by 41 publications

(30 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…3 Gemcitabine has been used in cervical cancers with good results both as a single agent and in combination with cisplatin concurrent with radiotherapy. [4][5][6][7][8][9][10][11][12][13][14] The aim of present study was to evaluate the toxicity and efficacy of concurrent weekly Gemcitabine against the widely accepted concurrent weekly cisplatin with standard convention radiotherapy in management of locally advanced cervical cancer.…”

Section: Introductionmentioning

confidence: 99%

Weekly cisplatin or gemcitabine concomitant with radiation in the management of locally advanced carcinoma cervix: results from an observational study

et al. 2009

View full text Add to dashboard Cite

Objective: The use of non-platinum drugs in concurrent chemoradiation in carcinoma cervix has not been well explored and hence a two arm study was planned to compare the outcome of concomitant cisplatin or gemcitabine in locally advanced carcinoma cervix. Methods: Thirty six patients were evaluated in this study for response rates and complications. These patients were divided into two arms, sixteen patients in the cisplatin arm and twenty patients in the gemcitabine arm. Cisplatin and gemcitabine were given as i.v. infusion at doses of 40 mg/m 2 and 150 mg/m 2 respectively for five weeks concomitant with radiotherapy. All patients had received pelvic radiotherapy to a dose of 50 Gy/25 fraction/5 weeks by four field box technique followed by high-dose-rate brachytherapy (3 sessions, each of 7.5 Gy to point A). Results: Median follow up was of 10.4 months (range, 3 to 36 months) and 10.9 months (range, 2 to 49 months) in the cisplatin and gemcitabine arms, respectively. At first follow up, 68.8% in the cisplatin arm and 70% in the gemcitabine arm had achieved complete response (p=0.93). Similar response rates were noted in different stages in both arms. None of the patients except one developed grade 4 toxicity. Similar toxicity profiles were observed in both arms. Local disease control, distant disease free survival and overall survival was 68.8% vs. 70%, 93.8% vs. 85%, 68.8% vs. 60% in the cisplatin and gemcitabine arms, respectively. Conclusion: Weekly gemcitabine had similar disease control and tolerable toxicity profile with cisplatin. Gemcitabine may be used as an alternative to cisplatin in patients with compromised renal function.

show abstract

Section: Introductionmentioning

confidence: 99%

Weekly cisplatin or gemcitabine concomitant with radiation in the management of locally advanced carcinoma cervix: results from an observational study

et al. 2009

View full text Add to dashboard Cite

show abstract

“…However; previous study using weekly cisplatin 40mg/m 2 had reported ototoxicity in 10% 15 while nephrotoxicity occurred in 42.9% in a study using weekly combination of gemcitabine with this standard dose of cisplatin. 16 Among hematologic toxicity; anemia was the most common (35.5%) followed by thrombocytopenia (31%) then neutropenia (26.6%) with grade 3 in 4.4% and no grade 4 that comparable to finding by Umanzor et al 6 However; Zarba et al 5 recorded grade 4 neutropenia in 4%. Anemia was found in 50% of patients treated with gemcitabine 125mg/m 2 and cisplatin 40mg/m 2 .…”

Section: Discussionmentioning

confidence: 58%

“…[4][5][6] Gemcitabine is activated intracellulary by deoxycytidine kinase and is converted into two active metabolites gemcitabine diphosphate and triphosphate which target DNA and RNA. It is considered to be an attractive compound to combine with ionizing radiation for several reasons: 1) It may inhibit repair of the DNA damage caused by radiation leading to increased cell death; 2) It may induce cell redistribution causing cells to accumulate in more radiosensitive phase of cell cycle; 3) Increased the radiosensitvity of hypoxic cells due to tumor shrinkage.…”

Section: Introductionmentioning

confidence: 99%

Concurrent pelvic radiation with weekly low-dose cisplatin and gemcitabine as primary treatment of locally advanced cervical cancer: A phase II study

El-Hadaad

Wahba

Roshdy

et al. 2015

Int J Cancer Ther Oncol

View full text Add to dashboard Cite

Original ArticleAbstract Purpose: This study was done to evaluate response, compliance and survival of weekly low dose cisplatin (20 mg/m 2 ) and gemcitabine (125 mg/m 2 ) concurrently with pelvic radiation as primary treatment of stage IIB-IIIB cervical cancer. Methods: External radiation consisted of 50 Gy/25 fractions using 6-10 MV photon followed by 600 cGy boost to parametrium if it was still felt thickened. Then, intracavitary radiotherapy to deliver 60 Gy at point A. Chemotherapy consisted of gemcitabine at a dose of 125 mg /m 2 was given by i.v infusion over 30 minutes immediately after cisplatin 20 mg /m 2 weekly for 5 weeks during EBRT. Fortyfive eligible patients received the treatment protocol. Results: Toxicity was tolerable and manageable. No grade 4 toxicity while grade 3 was recorded in hematologic one only. In order of frequency; diarrhea, nausea and vomiting, and anemia (50%, 40%, 35.5%) were most common adverse events. Overall clinical response rate was 93.4% with pathological complete response of 62.2%. After median follow-up of 20 months, 2-year survival and progression-free survival rates were 90.5% and 81% respectively. Conclusion: Weekly combination of low-dose cisplatin and gemcitabine given concurrently with pelvic radiotherapy in primary treatment of locally advanced cervical cancer resulted in a high response rate with a good compliance. Further exploration is needed for the use of this approach prior to incorporating it into routine clinical care through phase III clinical trial.

show abstract

“…However, even with the best results, the local recurrence is still high (around 19-24%). Zarba et al (2003), in a phase I-II study of weekly cisplatin and gemcitabine with concurrent radiotherapy in locally advanced cervical carcinoma, determined the MTD (Mean Toxic Dose) for gemcitabine to be 150mg/m 2 concurrent with cisplatin 40mg/m 2 every week and daily external radiotherapy. Furthermore, they recommended a phase II dose of gemcitabine at 125mg/m 2 plus cisplatin 40mg/m 2 weekly and external radiotherapy for locally advanced disease resulting in 36 patients showing an overall response of 97.3% with 88.8% of complete responses, 8.3% of partial responses and 2.7% of stable disease.…”

Section: Discussionmentioning

confidence: 99%

Concurrent Chemoradiation with Weekly Gemcitabine and Cisplatin for Locally Advanced Cervical Cancer

Hashemi

Akbari²,

Kalaghchi³

et al. 2013

Asian Pacific Journal of Cancer Prevention

View full text Add to dashboard Cite

A phase I–II study of weekly cisplatin and gemcitabine with concurrent radiotherapy in locally advanced cervical carcinoma

Abstract: The association of cisplatin and gemcitabine with concurrent radiotherapy is active and well-tolerated in untreated LACC.

Cited by 41 publications

References 13 publications

Weekly cisplatin or gemcitabine concomitant with radiation in the management of locally advanced carcinoma cervix: results from an observational study

Weekly cisplatin or gemcitabine concomitant with radiation in the management of locally advanced carcinoma cervix: results from an observational study

Concurrent pelvic radiation with weekly low-dose cisplatin and gemcitabine as primary treatment of locally advanced cervical cancer: A phase II study

Concurrent Chemoradiation with Weekly Gemcitabine and Cisplatin for Locally Advanced Cervical Cancer

Contact Info

Product

Resources

About