title: Platinum sensitivity and non-cross-resistance of cisplatin analogue with cisplatin in recurrent cervical cancer.
abstract: OBJECTIVE
  The concept of platinum sensitivity and cross-resistance among platinum agents are widely known in the management of recurrent ovarian cancer. The aim of this study was to evaluate two hypotheses regarding the validity of the concept of platinum sensitivity and non-cross-resistance of cisplatin analogue with cisplatin in recurrent cervical cancer.
  
  
  METHODS
  In this retrospective study, the clinical data of patients with recurrent cervical cancer, who had a history of receiving cisplatin based chemotherapy (including concurrent chemoradiotherapy [CCRT] with cisplatin) and who received second-line chemotherapy at the time of recurrence between April 2004 and July 2012 were reviewed.
  
  
  RESULTS
  In total, 49 patients--34 squamous cell carcinomas (69.4%) and 15 non-squamous cell carcinomas (30.6%)--were enrolled. The median age was 53 years (range, 26 to 79 years). Univariate and multivariate analysis showed that a platinum free interval (PFI) of 12 months has a strong relationship with the response rate to second-line chemotherapy. Upon multivariate analysis of survival after second-line platinum-based chemotherapy, a PFI of 12 months significantly influenced both progression-free survival (hazard ratio [HR], 0.349; 95% confidence interval [CI], 0.140 to 0.871; p=0.024) and overall survival (HR, 0.322; 95% CI, 0.123 to 0.842; p=0.021). In patients with a PFI of less than 6 months, the difference of progression-free survival between patients with re-administration of cisplatin (3.0 months) and administration of cisplatin analogue (7.2 months) as second-line chemotherapy was statistically significant (p=0.049, log-rank test).
  
  
  CONCLUSIONS
  The concept of platinum sensitivity could be applied to recurrent cervical cancer and there is a possibility of noncross-resistance of cisplatin analogue with cisplatin.
authors.affiliation: Department of Gynecology, Shizuoka Cancer Center Hospital, Sunto, Japan. m.takekuma@scchr.jp.
authors.forename: Munetaka
authors.initials: M
authors.lastname: Takekuma
authors.affiliation: Department of Gynecology, Shizuoka Cancer Center Hospital, Sunto, Japan.
authors.forename: Shiho
authors.initials: S
authors.lastname: Kuji
authors.affiliation: Department of Gynecology, Shizuoka Cancer Center Hospital, Sunto, Japan.
authors.forename: Aki
authors.initials: A
authors.lastname: Tanaka
authors.affiliation: Department of Gynecology, Shizuoka Cancer Center Hospital, Sunto, Japan.
authors.forename: Nobutaka
authors.initials: N
authors.lastname: Takahashi
authors.affiliation: Department of Gynecology, Shizuoka Cancer Center Hospital, Sunto, Japan.
authors.forename: Masakazu
authors.initials: M
authors.lastname: Abe
authors.affiliation: Department of Gynecology, Shizuoka Cancer Center Hospital, Sunto, Japan.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Hirashima
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000401:mortality; D002945:Cisplatin / Q000008:administration & dosage / Q000031:analogs & derivatives*; D019008:Drug Resistance, Neoplasm; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D019233:Retreatment; D012189:Retrospective Studies; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy* / Q000401:mortality
chemical_list: D009944:Organoplatinum Compounds; C053989:nedaplatin; D016190:Carboplatin; D002945:Cisplatin
keywords: Cisplatin; Disease-Free Survival; Neoplasm Recurrence, Local; Platinum; Uterine Cervical Neoplasms