A phase II study of weekly cisplatin followed by cisplatin and ifosfamide in advanced or recurrent cervical carcinoma

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Abstract
Background. Ifosfamide is an active agent in cis‐platin‐resistant cervical cancer. To determine the response rate of the combination of cisplatin and ifosfamide, a Phase II study was conducted of the administration of the combination after weekly cisplatin induction therapy. Methods. Forty‐seven patients with advanced or recurrent cervical carcinoma were treated with 1 mg/kg of cisplatin weekly for six courses, followed by 20 mg/m2 of cisplatin and 1.2 g/m2 of ifosfamide daily for 3 days every 28 days. Results. Objective responses were seen in 11 of 40 (27.5%) assessable patients (complete response, 20%; partial response, 7.5%). The duration of response ranged from 3 months to 26+ months (median, 9+ months). All of the patients who responded to the cisplatin‐ifosfamide combination initially responded to weekly cisplatin induction therapy. None of the four patients who had previously received chemotherapy responded. Grade 3 or 4 hematologic toxic effects occurred in 17 of 43 patients (39%). Neurologic and urologic toxic effects were infrequent. The current response rates are not better than the prior experience of the authors with other cisplatin combinations. Conclusions. These results do not confirm the favorable reports of other authors with cisplatin‐ifosfamide regimens in cervical carcinoma. The results of ongoing Phase III studies comparing cisplatin‐ifosfamide with cisplatin alone in cervical carcinoma are awaited.