Bleomycin, Methotrexate, and CCNU in Locally Advanced or Recurrent, Inoperable, Squamous-Cell Carcinoma of the Vulva: An EORTC Gynaecological Cancer Cooperative Group Study

Management of patients with vulvar cancer: a perspective review according to tumour stage

“…Combination therapy with cisplatin and vinorelbine lead to a progression-free survival of 10 months and overall survival of 19 months in a group of patients with recurrent disease after radiotherapy [Cormio et al 2009]. In a further study enrolling patients with locally advanced vulvar cancer the efficacy of a combination therapy with bleomycin, methotrexate and lomustine was analyzed (median overall survival 7.8 months) although significant side effects were noted [Wagenaar et al 2001]. Single-agent therapy with weekly paclitaxel appears to be less effective, with a mean progression-free survival of only 2.6 months [Witteveen et al 2009].…”

Medical Fellowship Programme within the Gynaecological Cancer Group of the European Organisation for Research and Treatment of Cancer

“…bleomycin/vincristine(oncovin)/mitomycin-C/cisplatin, was reduced to a 2-drug regimen (mitomycin-C/cisplatin) which could be administered in an outpatient clinic [5]. In the second study with bleomycin/ methotrexate/CCNU, the dosages of methotrexate were reduced to prevent or reduce bone marrow toxicity and mucositis [7]. The regimen cisplatin/vinblastine/bleomycin in granulosa cell tumours was based on the cisplatin/ vinblastine/bleomycin regimen in testicular cancer.…”

“…Three of the four phase II studies mentioned above were based on prior studies. Since two previous phase II studies had shown anti-tumour activity, the present trials in cervical and vulvar cancer were developed to reduce toxicity and to increase the quality of life [5,7]. In cervical cancer the 4-drug regimen, e.g.…”

“…Finalising her fellowship programme, H.C.W. was the second author of an EORTC/GCG paper [4] and the first author of four publications on three later EORTC/GCG studies and a study conducted at the Leiden University Medical Center [5][6][7][8].…”

“…Due to the rarity of these tumours, the number of Table 2. Overview of the four phase II trials in which the first author was actively involved during her medical research fellowship within the EORTC/GCG EORTC/GCG trial MP in cervical cancer [5] PVB in G(T)CTs of the ovary [4] CAP in Fallopian tube cancer [6] BM'C' in vulvar cancer [7] A = Adriamycin; B = bleomycin; C = cyclophosphamide; C' = CCNU; CT = chemotherapy; FIGO = International Federation of Gynaecology and Obstetrics; G(T)CT = granulosa (theca) cell tumour; M = mitomycin-C; M' = methotrexate; P = cisplatin; RT = radiotherapy; V = vinblastine. eligible patients accrued was close to the number of institutions that participated in each study.…”