title: Sustained complete response after maintenance therapy with topotecan and erlotinib for recurrent cervical cancer with distant metastases.
abstract: BACKGROUND
  Recurrent cervical cancer is associated with a poor prognosis. Most treatment responses are partial and of short duration. The development of new therapies is vital to improve treatment for recurrent disease. Epidermal growth factor receptor (EGFR) inhibitors may have a role in this setting.
  
  
  METHODS
  A 53-year-old woman with stage IB2 squamous cell carcinoma of the cervix was initially treated with chemoradiation. Six months after completing treatment, she developed a recurrence in the common iliac and para-aortic lymph nodes above the previous radiation field and was treated with additional radiation therapy. Two years later, she developed recurrent disease in the left supraclavicular lymph nodes and was treated with chemoradiation followed by 3 cycles of adjuvant cisplatin and topotecan. She had a complete response and was placed on maintenance therapy with topotecan and erlotinib, which was well tolerated and produced minimal side effects. After 20 months of maintenance therapy, it was discontinued given the long interval without evidence of disease. The patient is currently without evidence of disease 5 years after completing the topotecan-erlotinib treatment.
  
  
  CONCLUSIONS
  We noted a sustained response in a patient with recurrent metastatic cervical cancer treated with radiotherapy, cisplatin, and topotecan followed by maintenance therapy with topotecan and erlotinib. Further evaluation of the role of EGFR inhibitors in this setting should be considered given their favorable toxicity profile and biological relevance.
authors.affiliation: Department of Medical Oncology, Hospital Israelita Albert Einstein, São Paulo, Brazil.
authors.forename: Donato
authors.initials: D
authors.lastname: Callegaro-Filho
authors.affiliation: International Oncology Program, Chulalongkorn University, Bangkok, Thailand.
authors.forename: John J
authors.initials: JJ
authors.lastname: Kavanagh
authors.affiliation: Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Tex., USA.
authors.forename: Alpa M
authors.initials: AM
authors.lastname: Nick
authors.affiliation: Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Tex., USA.
authors.forename: Pedro T
authors.initials: PT
authors.lastname: Ramirez
authors.affiliation: Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Tex., USA.
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Schmeler
keywords: Epidermal growth factor receptor inhibitor; Erlotinib; Maintenance therapy; Recurrent cervical cancer