Chemotherapy for metastatic and recurrent cervical cancer

Scatchard, Kate; Forrest, J.; Flubacher, M.; Cornes, Paul; Williams, Chris

doi:10.1002/14651858.cd006469.pub2

Cited by 63 publications

(59 citation statements)

References 43 publications

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“…Reports of an excellent complete response in metastatic cervical cancer are rare. A review on chemotherapy for metastatic and/or recurrent cervical cancer (Scatchard et al, 2012) found that in two randomized control studies, the median survival of patients after single agent cis-platin chemotherapy for metastatic disease was 17 (Alberts et al, 1987) and 13 (Cadron et al, 2005) months respectively. It is therefore interesting to speculate as to whether the DC vaccine had a contributory role in this patient achieving a sustained disease free status.…”

Section: Discussionmentioning

confidence: 99%

Development and Clinical Evaluation of Dendritic Cell Vaccines for HPV Related Cervical Cancer - a Feasibility Study

Ramanathan¹,

Ganesarajah²,

Raghanvan³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Human papillomavirus infection (HPV) and HPV related immune perturbation play important roles in the development of cervical cancer. Since mature dendritic cells (DCs) are potent antigen-presenting cells (APC), they could be primed by HPV antigens against cervical cancers. In this study we were able to generate, maintain and characterize, both phenotypically and functionally, patient specific dendritic cells in vitro. A randomized Phase I trial with three arms -saline control (arm I), unprimed mature DC (arm II) and autologous tumor lysate primed mature DC (arm III) and fourteen patients was conducted. According to WHO criteria, grade 0 or grade one toxicity was observed in three patients. One patient who received tumor lysate primed dendritic cells and later cis-platin chemotherapy showed a complete clinical response of her large metastatic disease and remained disease free for more than 72 months. Our findings indicate that DC vaccines hold promise as adjuvant sfor cervical cancer treatment and further studies to improve their efficacy need to be conducted.

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Section: Discussionmentioning

confidence: 99%

Development and Clinical Evaluation of Dendritic Cell Vaccines for HPV Related Cervical Cancer - a Feasibility Study

Ramanathan¹,

Ganesarajah²,

Raghanvan³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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“…Cervical cancer remains a significant public health concern worldwide (2,5,6), particularly among women aged ≤65 years or in developing countries (11)(12)(13). Approximately one-third of patients with invasive, recurrent, or metastatic cervical cancer eventually succumb to the disease.…”

Section: Discussionmentioning

confidence: 99%

Patient age, tumor appearance and tumor size are risk factors for early recurrence of cervical cancer

Wang

Yang

et al. 2014

Molecular and Clinical Oncology

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Abstract. The recurrence and metastasis of cervical cancer contribute to a poor prognosis. The aim of this study was to investigate the risk factors for cervical cancer progression. A total of 284 patients with recurrent cervical cancer were retrospectively recruited to evaluate the association of disease recurrence with clinicopathological data. The univariate analysis demonstrated that patient age, tumor appearance and tumor size were significantly associated with early recurrence and metastasis of the disease (P<0.05). However, clinical stage, tumor histology, pathological stage and initial treatment options were not associated with early recurrence and metastasis of cervical cancer (P>0.05). The multivariate analysis also demonstrated that patient age, tumor appearance and tumor size were independent risk factors for the early recurrence of cervical cancer (P<0.05). Therefore, these three factors should be taken into consideration in the management of cervical cancer.

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“…In a Cochrane database review, Scatchard et al [10] analyzed 10 randomized trials assessing 1,438 participants. There was no statistically significant difference in response rate between women who received single-agent chemotherapy and those who received combination therapy (response rate 0.94, 95% CI 0.57-1.55).…”

Section: Kumar/guptamentioning

confidence: 99%

Integrating Chemotherapy in the Management of Cervical Cancer: A Critical Appraisal

Kumar

Gupta

2016

Oncology

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The management of locally advanced cervix cancer has undergone a paradigm shift during the last decade. Concurrent chemoradiation (CCRT) (with cisplatin alone or in combination) is currently the standard treatment approach. CCRT results in a 5-year overall survival rate of 66% and a disease-free survival of 58%. About 30-40% of patients with locally advanced cervical cancer fail to achieve complete response to CCRT; alternative approaches are needed to improve the outcome for such patients. Weekly paclitaxel and carboplatin for 4-6 weeks as dose-dense chemotherapy prior to CCRT could be one such potential approach. The role of adjuvant chemotherapy after CCRT in patients with positive lymph nodes, larger tumor volume and stage III-IVA disease needs further exploration. Adjuvant chemotherapy is also being investigated for early-stage (stages IA2, IB1 or IIA) cervical cancer with presence of risk factors such as lymph node metastasis, lymphovascular space invasion and invasion depth of more than 10 mm, microscopic parametrial invasion, non-squamous histology and positive surgical margins. For patients with early-stage disease (IA2-IIA), short-course chemotherapy prior to surgery is associated with an improved outcome in many studies. Neo-adjuvant chemotherapy followed by fertility preservation surgery is feasible in carefully selected young patients with bulky stage IB1 disease. Recently, a number of molecular pathways have been identified as potential therapeutic targets. Bevacizumab - an inhibitor of vascular endothelial growth factor - is associated with improved survival in patients with recurrent/metastatic cervical cancer. Whether bevacizumab and other similar novel agents targeting molecular pathways could be used in front-line treatment along with cytotoxic chemotherapy is likely to be an area of research in future studies.

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Chemotherapy for metastatic and recurrent cervical cancer

Cited by 63 publications

References 43 publications

Development and Clinical Evaluation of Dendritic Cell Vaccines for HPV Related Cervical Cancer - a Feasibility Study

Development and Clinical Evaluation of Dendritic Cell Vaccines for HPV Related Cervical Cancer - a Feasibility Study

Patient age, tumor appearance and tumor size are risk factors for early recurrence of cervical cancer

Integrating Chemotherapy in the Management of Cervical Cancer: A Critical Appraisal

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