Phase II study of vincristine, bleomycin, mitomycin C and cisplatin (VBMP)in disseminated squamous cell carcinoma of the uterine cervix

The objective of this study was to study the antitumor activity of the vinc ristine, bleomycin, mitomycin C and cisplatin (VBMP) scheme in patients wit h disseminated squamous cell carcinoma of the uterine cervix and to documen t its toxicity. VBMP consisted of vincristine 1.4 mg/ m(2) (max. 2 mg) i.v. day 1, bleomycin 15 mg/day by continuous i.v. infusion on day 1 + 2,mitomy cin C 6 mg/m(2) i.v. day 3 and cisplatin 50 mg/m(2) i.v. day 4, and was giv en every 4 weeks. Bleomycin was withdrawn from the schedule after a cumulat ive dose of 300 mg (210 mg in patients over 60). Thereafter VMP continued ( V + M day 1, P day 2) with the same interval. A median number of 4.5 (range 2-13) treatment cycles was given to 50 fully evaluable patients, 26 with o nly distant metastases (group A) and 24 with pelvic disease also (23 previo usly irradiated) (group B). All patients were < 70 years old, had a Karnofs ky index <greater than or equal to>60, and measurable metastatic lesions ou tside previously irradiated areas. They all had normal organ functions and gave informed consent. Response in group A was 54% (31% complete), in group B 25% (all partial), 40% in all. Median time to progression in group A was 20 weeks and in group B 15 weeks; median survival was 42 weeks in group A, 32 weeks in group B, 37 weeks for all patients. Hematologic toxicity was cu mulative and the majority of patients needed blood transfusions. Nonhematol ogic toxicity was acceptable, but in one patient pulmonary toxicity might h ave contributed to death. Although it is active, it is unclear whether this regimen is superior to cisplatin alone.