Uterine carcinosarcoma: An overview

Comparing paclitaxel-platinum with ifosfamide-platinum as the front-line chemotherapy for patients with advanced-stage uterine carcinosarcoma

“…During a median follow-up of 60 months, the authors found the best outcomes (PFS = 35 months, 95 % CI, 0.26-0.43; OS = 47 months, 95 % CI, 0.38-0.56) in women treated with IP. 49 However, recent evidence supports that UCS is various forms of poorly differentiated uterine carcinomas, 1,2,13,17,[29][30][31][32] contributing to the reconsideration of the use of paclitaxel in place of ifosfamide for UCS. 35,36 Powell et al 35 conducted a single-arm phase II GOG-232B trial to evaluate the efficacy of PP for recurrent or metastatic UCS to obtain 13% and 41%, of compete and partial response rates, respectively, in 55 advanced UCS (stage III and IV) patients.…”

“…We only evaluated the outcome of patients with FIGO III to IV UCS, compared to other studies enrolling all FIGO I to IV UCS. 32,54,55 Furthermore, consideration of statistical significance or no statistical significance should be carefully interpreted whether this "statistical significance" or "no statistical significance" is clinically meaningful. [56][57][58][59][60] The statistical significance is only a really reflective of the findings of the study based on the reliability of the study results, but it may not be totally presentative of "the extent of change".…”

“…The widely acceptable chemotherapy agents are platinum (either cisplatin or carboplatin), ifosfamide, and paclitaxel. [30][31][32][33][34][35][36][37] To date, the standard or preferred adjuvant chemotherapy regimen and schedule for UCS are still uncertain. 31 Single agent has been frequently used for UCS due to its moderate effect and its tolerable toxicity.…”

“…Based on the key role of ifosfamide for the treatment of UCS, nearly all chemotherapy regimens, either single agent or multiagents included ifosfamide, although significant toxicities should be weighted. 2,22,32,33,37 Paclitaxel is considered as a potential agent for UCS, based on the experience on endometrial cancer. Additionally, combination of paclitaxel and platinum (paclitaxel-platinum regimen: PP) was widely used in the majority of gynecological organ-related cancers.…”

“…Radiotherapy, chemotherapy, targeted therapy, and some investigated agents, as well as the combination of any of the above-mentioned therapies (called as multimodality treatment), are believed to provide potentially positive impacts on patients with UCS, and this adjuvant therapy is also apparently beneficial in those with an early UCS. [1][2][3][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37] A recent meta-analysis summarizing four studies, which enrolled 2416 patients (939 patients treated with surgery plus postoperative chemotherapy and 1477 patients treated with surgery alone) found that 5-year overall survival (OS) was statistically significantly improved in the combination of surgery and adjuvant chemotherapy group compared to that in the surgery alone group, 23 suggesting that adjuvant chemotherapy should be considered in all UCS patients, regardless of what stages they are. The widely acceptable chemotherapy agents are platinum (either cisplatin or carboplatin), ifosfamide, and paclitaxel.…”