ReviewA systematic review comparing cisplatin and carboplatin plus paclitaxel-based chemotherapy for recurrent or metastatic cervical cancer
Introduction
Cervical cancer is still a leading cause of cancer-related death in women, accounting for 14% of all deaths due to gynecologic cancers worldwide [1]. Although several advances in screening, diagnostic and treatment modalities have been made, the overall prognosis of cervical cancer has not changed dramatically, and the mortality still approaches 50%. The treatment of choice of cervical cancer is represented by radiotherapy or surgery for early stage disease and concurrent chemoradiation for advanced stage patients. Chemotherapy remains an option for metastatic patients (FIGO stage IVB) or persistent/recurrent disease after primary treatment not suitable for curative surgery or radiotherapy. The prognosis of advanced/recurrent patients generally remains poor with 1-year survival ranging between 15 and 20% [2]. Single agent cisplatin (CDDP) is considered the most active agent in the treatment of advanced/recurrent disease [3], and the combination of CDDP-paclitaxel (P) has been reported to be better to CDDP monotherapy in terms of response rate (RR), progression free survival (PFS) but not overall survival (OS) [4]. The recently closed GOG 204 moreover reported CDDP-P as the most active combination in the treatment of advanced or recurrent cervical cancer [5] thus confirming the treatment as the new standard of care in advanced cervical carcinoma. Unfortunately, the toxicity of the treatment and the discomfort of the schedule, with P given as 24-hour infusion in order to minimize neurologic toxicity, make the combination hardly to propose in a setting of disease where, despite the improved clinical outcomes, all treatments remain palliative in the finality. In this context, CBDCA, with its more favorable toxicity profile and the convenience of the outpatient administration, may be a suitable substitute of CDDP in combination regimens. In ovarian cancer, CBDCA has been reported to be equally effective than CDDP but better tolerated [6], [7]. Recently a randomized JCOG phase III trial on stage IVB, persistent or recurrent cervical cancer reported that CBDCA-P is equally effective with respect to CDDP-P in terms of PFS and OS, the latter being more efficacious in chemo naive patients [8]. We performed a systematic review of the literature comparing CDDP and CBDCA paclitaxel-based chemotherapy for recurrent or metastatic cervical cancer in order to describe the activity and outcomes associated with both doublets.
Section snippets
Literature search
PubMed, EMBASE, Web of Science and The Cochrane Library were systematically searched in March 2013, to identify relevant publications. Keywords included in the search were “uterine cervical neoplasm [Mesh]”, “cisplatin or carboplatin”, “paclitaxel” and “recurrent or relapsed or advanced or metastatic”. The literature search was limited to “human studies” in “English” language. We also reviewed conference abstracts to identify unpublished papers. All potentially relevant studies were retrieved,
Literature search and study characteristics
The flow of study selection is reported in Fig. 1. Initially, 860 references were identified (PubMed: n = 138, Web of Science: n = 262, Cochrane register of Controlled trials: n = 26, EMBASE: n = 434). After careful selection, a total of 17 eligible studies comprehensive of 1181 patients were included in the final analysis (7 for CBDCA/paclitaxel analysis, 9 for CDDP/paclitaxel analysis and 1 for both analyses) [4], [5], [8], [11], [12], [13], [14], [15], [16], [17], [18], [19], [22], [23], [24], [25],
Discussion
The experience with substituting CBDCA for CDDP is limited in advanced or recurrent uterine cervical cancer, and our systematic literature review seems to confirm that CDDP and CBDCA are equally effective in the treatment of the disease. Traditionally CDDP, with RRs ranging from 20 to 30% and OS of 7 months [20], has been considered the most effective single agent for cervical cancer treatment. Even in the absence of a direct comparison, other platinum analogs were considered less active than
Conflict of interest statement
The authors declare no conflict of interest.
References (28)
- et al.
Meta-analysis in clinical trials
Control Clin Trials
(1986) - et al.
Combination of ifosfamide, paclitaxel, and cisplatin for the treatment of metastatic and recurrent carcinoma of the uterine cervix: a phase II study of the Hellenic Cooperative Oncology Group
Gynecol Oncol
(Jun 2002) - et al.
Randomized multicenter phase II trial of cisplatin and ifosfamide with or without paclitaxel in recurrent or metastatic carcinoma of the uterine cervix: a Hellenic Cooperative Oncology Group (HeCOG) study
Ann Oncol
(Aug 2009) - et al.
Paclitaxel, ifosfamide and cisplatin (TIP) chemotherapy for recurrent or persistent squamous-cell cervical cancer
Ann Oncol
(Oct 1999) - et al.
Ifosfamide, paclitaxel, and carboplatin, a novel triplet regimen for advanced, recurrent, or persistent carcinoma of the cervix: a phase II trial
Gynecol Oncol
(Feb 2011) - et al.
The activity of carboplatin and paclitaxel for recurrent cervical cancer after definitive radiotherapy
Gynecol Oncol
(May 2009) - et al.
Evaluation of paclitaxel/carboplatin in a dose dense or weekly regimen in 66 patients with recurrent or primary metastatic cervical cancer
Eur J Cancer
(Jun 2012) - et al.
Cancer statistics, 2007
CA Cancer J Clin
(2007) - et al.
Chemotherapy for recurrent cervical cancer
Gynecol Oncol
(2007) - et al.
Cis-dichlorodiammineplatiunm (II) in the treatment of gynecologic malignancies: phase II trials by the Gynecologic Oncology Group
Cancer Treat Rep
(1979)
Phase III study of cisplatin with or without paclitaxel in stage IVB, recurrent or persistent squamous cell carcinoma of the cervix: a Gynecologic Oncology Group study
J Clin Oncol
Phase III trial of four cisplatin-containing doublet combinations in stage IVB, recurrent, or persistent cervical carcinoma: a Gynecologic Oncology Group study
J Clin Oncol
Phase III trial of carboplatin and paclitaxel compared with cisplatin and paclitaxel in patients with optimally resected stage III ovarian cancer: a Gynecologic Oncology Group study
J Clin Oncol
Carboplatin/paclitaxel versus cisplatin/paclitaxel as first-line chemotherapy in advanced ovarian cancer: an interim analysis of a randomized phase III trial of the Arbeitsgemeinschaft Gynakologische Onkologie Ovarian Cancer Study Group
Semin Oncol
Cited by (170)
Cervical cancer: Novel treatment strategies offer renewed optimism
2024, Pathology Research and PracticeCellular landscaping of cisplatin resistance in cervical cancer
2022, Biomedicine and PharmacotherapyPaclitaxel-carboplatin and bevacizumab combination with maintenance bevacizumab therapy for metastatic, recurrent, and persistent uterine cervical cancer: An open-label multicenter phase II trial (JGOG1079)
2022, Gynecologic OncologyCitation Excerpt :A phase III non-inferiority clinical trial (JCOG0505) comparing paclitaxel–carboplatin combination therapy (TC therapy) with TP therapy demonstrated significant non-inferiority upon substitution of cisplatin with carboplatin [hazard ratio (HR): 0.994] [2]. However, this TC therapy regimen has been widely used in patients with uterine cervical cancer owing to its convenience [3]. Subsequently, the GOG240 trial in 2014 demonstrated that incorporating targeted therapy using bevacizumab, an agent in anti-vascular endothelial growth factor (VEGF) therapy, dramatically improved overall survival (OS) in patients with metastatic, recurrent, and persistent uterine cervical cancer [4–7].
Overexpression of Secreted Phosphoprotein 1 (SPP1) predicts poor survival in HPV positive cervical cancer
2022, GeneCitation Excerpt :SPP1 upregulation is associated with cervical cancer invasion (Song et al., 2008) and is considered a candidate biomarker for cervical cancer (Cho et al., 2008). Reports stated that cisplatin drug-based pivotal chemotherapy is an effective strategy employed against cervical cancer metastasis (Lorusso et al., 2014), however; long exposure to this drug induces resistance thereby impeding anticancer activity (Zhu et al., 2016). Researchers have also focused at the connection between SPP1 expression and chemo-resistance in carcinogenesis.
Discovery of pyrimidine-bridged CA-4 CBSIs for the treatment of cervical cancer in combination with cisplatin with significantly reduced nephrotoxicity
2022, European Journal of Medicinal Chemistry