title: Evaluation of the paclitaxel-ifosfamide-cisplatin (TIP) combination in relapsed and/or metastatic cervical cancer.
abstract: BACKGROUND
  Recurrent or metastatic cervical cancer represents an aggressive malignancy with a high rate of locoregional and distant failure. Therefore, we evaluated the three-drug combination of paclitaxel-ifosfamide-cisplatin (TIP).
  
  
  METHODS
  Systemic chemotherapy-naive patients with advanced metastatic/relapsed cervical cancer and a World Health Organization (WHO) performance status (PS) of 0-2 were eligible. TIP chemotherapy doses were paclitaxel 175 mg m(-2) on day 1, ifosfamide 2.5 g m(-2) on days 1+2, and cisplatin 40 mg m(-2) on days 1+2, with prophylactic granulocyte-colony stimulating factor.
  
  
  RESULTS
  A total of 42 patients with recurrent/metastatic cervical cancer are evaluable for response and toxicity: median age: 56 (25-74) years; PS: 1 (0-2); histologies - squamous: 35, adenosquamous: 5, and adenocarcinoma: 2. Responses were overall response rate (RR): 62% (95% confidence interval (CI): 47.3-76.7%), with complete response (CR): 26% (95% CI: 12.7-39.3%), and partial response (PR): 36% (95% CI: 21.5-49.9%). Responses according to the relapse site were overall RR: 32% (95% CI: 13.7-50.3%) within previously irradiated pelvis vs 75% (95% CI: 57.7-92.3%) in extra-pelvic sites. Median time to progression (TTP) was 7 (range, 2-34+) months and median overall survival (OS) was 16.5 (range, 3-36+) months. Toxicities included grade 3-4 neutropenia: 83% (21% febrile neutropenia), grade 3-4 thrombocytopenia: 9%, no grade 3 neuropathy (35% grade 2), grade 2 asthenia/fatigue 15%, and no treatment-related deaths.
  
  
  CONCLUSIONS
  TIP is an active regimen with acceptable toxicity in advanced/relapsed cervical cancer.
authors.affiliation: Second Division of Medical Oncology, Department of Medicine, 'Metaxa' Cancer Hospital, Pireaus, Greece. ckosm1@ath.forthnet.gr
authors.forename: C
authors.initials: C
authors.lastname: Kosmas
authors.forename: N
authors.initials: N
authors.lastname: Mylonakis
authors.forename: G
authors.initials: G
authors.lastname: Tsakonas
authors.forename: G
authors.initials: G
authors.lastname: Vorgias
authors.forename: N
authors.initials: N
authors.lastname: Karvounis
authors.forename: N
authors.initials: N
authors.lastname: Tsavaris
authors.forename: T
authors.initials: T
authors.lastname: Daladimos
authors.forename: N
authors.initials: N
authors.lastname: Kalinoglou
authors.forename: N
authors.initials: N
authors.lastname: Malamos
authors.forename: T
authors.initials: T
authors.lastname: Akrivos
authors.forename: A
authors.initials: A
authors.lastname: Karabelis
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage / Q000009:adverse effects; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy; D017239:Paclitaxel / Q000008:administration & dosage / Q000009:adverse effects; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology
chemical_list: D017239:Paclitaxel; D002945:Cisplatin; D007069:Ifosfamide