A PHASE-II STUDY OF IFOSFAMIDE, CARBOPLATIN AND CISPLATIN IN ADVANCEDAND RECURRENT SQUAMOUS-CELL CARCINOMA OF THE UTERINE CERVIX

Background: Discouraging response durations and long-time survivals ha ve so far been the result of cisplatin-containing combination chemothe rapy against advanced or recurrent squamous cell carcinoma of the uter ine cervix. In order to increase the platinum-based effect upon this t umor without an increase in the specific toxicity of cisplatin, we com bined it with carboplatin, added ifosfamide, which has been shown to p ossess a comparable degree Of Single-agent activity. Patients and Meth ods: Thirty-six patients with advanced or recurrent squamous cell carc inoma of the uterine cervix not curable by radiation or surgery were t reated with a combination of ifosfamide 1.5 gr/m2 i.v. days 1-3, carbo platin 200 mg/m2 i.v. day 1, and cisplatin 50 mg/m2. Thirty-one patien ts were evaluable for response and 34 patients for toxicity. Results: Twenty-three patients responded (64%), 11 (31%) of them completely, an d 12 (33%) partially. Median response duration was 23 weeks (range 8-1 07 weeks), reaching 27 weeks and 21 weeks for patients with and withou t disease in previously irradiated areas, respectively. Median surviva l is 40 weeks (range 1-114 weeks). Toxicity consisted mainly of modera te to severe myelosuppression, resulting in 2 toxic deaths. Conclusion : The response rate, also for earlier irradiated areas, compares favor ably with other known cisplatin-containing regimens. The combination d eserves investigation in a randomized setting.