title: Weekly topotecan as second- or third-line treatment in patients with recurrent or metastatic cervical cancer.
abstract: Topotecan is active in advanced or metastatic cervical cancer even in patients who have received prior cisplatin-based chemotherapy, although hematologic toxicity has limited its use. Studies in cervical cancer have utilized topotecan administered on days 1-5 of each 21- or 28-day cycle. Alternative schedules, such as weekly schemes, have proven to ameliorate hematological toxicity. The objective of this study was to analyze the results of weekly topotecan as second- or third-line therapy in advanced or metastatic cervical cancer. Eligible patients had histologically confirmed cervical carcinoma, measurable disease, and at least one prior chemotherapy regimen. Topotecan was administered at a dose of 3 mg/m(2) (maximum, 5 mg per dose) diluted in 250 ml of normal saline in a 30-min infusion weekly for every 28 days. We assessed response and toxicity. Twenty-two patients entered this study. Eighteen patients were evaluable for toxicity and response. Patients received a mean 3.5 courses (range, 1-6 courses). No complete or partial responses were observed; five (27.7%) patients exhibited disease stabilization as maximum response (two in irradiated sites, and three in lung/mediastinum). Median progression-free interval was 3.5 months (95% confidence interval [CI]: 3.75-4 months) and median overall survival was 7 months (95% CI: 6-8.7 months). Weekly topotecan administration achieved disease stabilization in 27.7% of heavily pre-treated patients. The achievement could be of worth in this setting in which disease prolongation is desirable.
authors.affiliation: Division of Clinical Research, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico. quiechc8@hotmail.com
authors.forename: Jaime
authors.initials: J
authors.lastname: Coronel
authors.forename: Lucely
authors.initials: L
authors.lastname: Cetina
authors.forename: Myrna
authors.initials: M
authors.lastname: Candelaria
authors.forename: Aurora
authors.initials: A
authors.lastname: González-Fierro
authors.forename: Daimy
authors.initials: D
authors.lastname: Arias
authors.forename: David
authors.initials: D
authors.lastname: Cantu
authors.forename: Alfonso
authors.initials: A
authors.lastname: Dueñas-González
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D016019:Survival Analysis; D019772:Topotecan / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology
chemical_list: D000970:Antineoplastic Agents; D019772:Topotecan