Topotecan for recurrent cervical cancer after platinum-based therapy

The activity and toxicity of topotecan in women with recurrent cervical can cer are described from a case series of women with recurrent cervical cance r who had measurable disease and were not amenable to cure by surgery or ra diation. All patients had prior platinum-based chemotherapy and developed p rogressive disease. Topotecan was given as 1 mg/m(2)/day over 30 min for 5 days every 3 weeks until progression of disease or prohibitive toxicity. Be tween July 1998 and July 1999, 12 patients received a total of 20 cycles of topotecan. Median age was 41 years (range 21-62), and 11 (92%) patients ha d prior whole pelvic radiation. The mean number of topotecan cycles was 1.5 (median 5 range 1-3). There were two partial responses (16.7%; 95% CI, 2% to 48%), both in prior radiation fields. Five patients required red blood c ell transfusions, four had grade II nausea and vomiting, two developed seps is (one with neutropenia), one developed fever, and one reported hyperpigme ntation. There were no treatment-related mortalities. Although topotecan ap pears to exhibit modest activity in recurrent cervical cancer after radiati on and platinum-based therapy, bone marrow toxicity may limit the utility o f this regimen without hematopoietic growth factor support.