Capecitabine in patients with platinum-pretreated advanced or recurrent cervical carcinoma: a retrospective study

Abstract

BackgroundCervical cancer is a common malignancy among women and, when recurring, presents a dismal prognosis. After platinum failure, second-line treatments report response rates ranging from 3–15%, a median progression-free survival of about 3 months and a median overall survival of about 5.5 months.To retrospectively evaluate the activity and safety of capecitabine in patients with advanced/recurrent cervical carcinoma.MethodsA retrospective review of medical records of recurrent cervical cancer patients, who had failed a previous platinum–paclitaxel treatment and received oral capecitabine 1250 mg/m2 twice daily continuously from day 1 to day 14 every 21 days, was performed from December 2013 to March 2018 at the Gynecologic Oncology Unit of the Fondazione IRCCS National Cancer Institute of Milan, Italy. The response rate was evaluated every three cycles according to Response Evaluation Criteria In Solid Tumors (RECIST) version 1.1 criteria. Common Terminology Criteria for Adverse Events version 4.0 were used to evaluate adverse events.ResultsWe retrospectively analyzed 35 patients with recurrent cervical carcinoma, treated with oral capecitabine. All patients had previously received and failed a combination of carboplatin plus paclitaxel as first-line therapy for advanced/recurrent disease. Median age at the first capecitabine administration was 53 years (range 27–82). All patients were evaluable for response: the overall response rate was 34.2% (2.8% complete responses and 31.4% partial responses) with a clinical benefit rate of 57% (overall response rate plus 22.8% stabilizations of disease). The most common grade 1–2 adverse events per patient were fatigue (71.3%), hand-foot syndrome (57.0%), diarrhea (31.3%), constipation (17.0%), and nausea (10.4%). Only three patients (8.5%) reported grade 3 adverse events.ConclusionsOur data suggest that oral capecitabine should be considered an active and safe treatment in patients with recurrent cervical carcinoma after platinum failure. Based on these results, we consider capecitabine as warranting further clinical evaluation.

Efficacy and Safety of Oral Metronomic Chemotherapy in Recurrent Refractory Advanced Gynaecological Cancer: An Experience From the Regional Cancer Centre of Eastern India

“…The study was stopped prematurely because of futility; the drug was claimed to be ineffective, even though a 15.4% ORR and a 34.6% stable disease rate (SDR) were documented [ 18 ]. Recently published, Maltese et al's research showed a clinical benefit rate of 57% and an ORR of 34.2% using capecitabine in recurrent cervical cancer [ 19 ]. A pilot phase II study on a population of 30 stage IVB or recurrent cervical cancer patients who had received >1 chemotherapy regimens reported a 43.3% ORR with a median time to progression of 4.4 months and a median OS of 10.2 months with S-1 (an oral anticancer drug comprised of tegafur, gimeracil and oteracil) at a dose of 40-60 mg/m 2 twice daily for six weeks [ 20 ].…”

Long-term Quality of Life and Sexual Function After Neoadjuvant Chemotherapy and Radical Surgery for Locally Advanced Cervical Cancer

“…3,4 The 5-year overall survival (OS) for all stages is around 65%: more than 90% for stage I disease, 50−60% for stage II-IVA disease, and only 15−20% in case of distant metastases (stage IVB). 5,6 Cervical cancer survivors report the worst quality of life (QoL) and sexual function among all cancer survivors. [7][8][9][10][11] The rationale behind lies in the younger age and the long-term sequelae related to the aggressive cancer treatments (ie, radiotherapy, chemotherapy, surgery or combinations).…”

Concomitant Chemo-Radiotherapy with Oral Capecitabine in Locally Advanced Squamous Cell Carcinoma Cervix

“…Cervical carcinoma is the fourth most common malignancy 1,2 . According to an estimate almost women (16/100,000/year) get cervical carcinoma with mortality occurs in 9/16 of its victims annually 3,4 .…”