A randomized comparative trial of carboplatin and iproplatin in advanced squamous carcinoma of the uterine cervix: a Gynecologic Oncology Group study.

Abstract

A total of 394 patients with advanced, measurable squamous carcinoma of the uterine cervix and no prior chemotherapy were randomized to therapy with either carboplatin or iproplatin. There were 23 patients ineligible for the study and 10 patients who were not evaluable; the remaining 361 patients were evaluable for response and adverse effects. Randomization was well balanced for age, performance status, and prior therapy. Both platinum analogs were given every 28 days with starting doses of 400 mg/m2 for carboplatin (340 mg/m2 if the patient underwent prior radiation) and 270 mg/m2 for iproplatin (230 mg/m2 if the patient underwent prior radiation). These doses are equivalent to cisplatin doses of 75 to 100 mg/m2. Hematologic toxicity was dose-limiting, among which thrombocytopenia was slightly more common than leukopenia. Gastrointestinal toxicity was also prominent with both agents; however, iproplatin was significantly more toxic than carboplatin (P less than .001). Renal, otic, and peripheral nervous system toxicities were absent or infrequent with both analogs. No electrolyte abnormalities were observed. The percentage of planned dosages that were actually administered was 100% of carboplatin doses and 85% of iproplatin doses (P less than .0001). The reduction in iproplatin dose was apparently due to gastrointestinal toxicity. Response rates were similar for both agents (15% for carboplatin, 11% for iproplatin) and appear to be inferior to those noted with the parent compound, cisplatin.

Phase I-II study of carboplatin vincristine methotrexate and bleomycin (COMB) in carcinoma of the cervix

“…Carboplatin and cisplatin appear to have equal antitumour activity as single agents against ovarian carcinoma (Wiltshaw, 1985;Canetta et al, 1985), but recent data suggest that carboplatin may be less effective than cisplatin against cervical carcinoma (McGuire et al, 1988;Bonomi et al, 1985). This probably explains the low response rate of COMB.…”

Expression of anionic glutathione S transferase (GSTπ) gene in carcinomas of the uterine cervix and in normal cervices

“…As expected, two DNA bands of 6.2 and 5.0 kb were observCervical cancers are treated by surgery, radiation and cytotoxic drugs (Friedlander et al, 1983;Haie et al, 1988;McGuire et al, 1989). Treatment depends on prognosis which is determined by clinicopathological parameters of which the most important are clinical stage at diagnosis and nodal status (Pejovic et al, 1981).…”

“…Patients with invasive carcinoma of the uterine cervix are treated by surgery, radiation and/or chemotherapy (Friedlander et al, 1983;McGuire et al, 1989 …”

“…The anionic isoenzyme glutathione S transferase (GSTx) which belongs to a complex group of drug-detoxifying enzymes, was present at high levels in the MCF7 breast cancer cell line resistant to Doxorubicine (DXR) together with high levels of MDRI transcripts (Batist et al, 1986;. Although the precise role of GST7 in the development of resistance is not known, its expression may be one among the numerous phenotypic and biochemical changes which accompany drug resistance in some cancers.Patients with invasive carcinoma of the uterine cervix are treated by surgery, radiation and/or chemotherapy (Friedlander et al, 1983;McGuire et al, 1989 …”

PRO: Patients With Metastatic/Recurrent Cervical Cancer Should Be Treated With Cisplatin Plus Paclitaxel

“…13 The early trials of the GOG for recurrent and metastatic cervical carcinoma were designed to evaluate cisplatin dosing, 14 schedules, 15 and analogues. 16 The next 2 trials evaluated the addition of ifosfamide, bleomycin, and mitolactol to cisplatin-based therapies. 17,18 Among some of the lessons learned during the 1980s and 1990s governing chemotherapy for recurrent cervical cancer were that platinum-based therapies were most effective, and that cisplatin was more active than carboplatin (response rates [RRs], 19% vs. 15%, respectively).…”