A phase II study of ifosfamide, carboplatin and cisplatin in advanced and recurrent squamous cell carcinoma of the uterine cervix

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Abstract
Discouraging response durations and long-time survivals have so far been the result of cisplatin-containing combination chemotherapy against advanced or recurrent squamous cell carcinoma of the uterine cervix. In order to increase the platinum-based effect upon this tumor without an increase in the specific toxicity of cisplatin, we combined it with carboplatin, added ifosfamide, which has been shown to possess a comparable degree of single-agent activity. Thirty-six patients with advanced or recurrent squamous cell carcinoma of the uterine cervix not curable by radiation or surgery were treated with a combination of ifosfamide 1.5 gr/m2 i.v. days 1–3, carboplatin 200 mg/m2 i.v. day 1, and cisplatin 50 mg/ml2 Thirty-one patients were evaluable for response and 34 patients for toxicity. Twenty-three patients responded (64%), 11 (31%) of them completely, and 12 (33%) partially. Median response duration was 23 weeks (range 8–107 weeks), reaching 27 weeks and 21 weeks patients with and without disease in previously irradiated areas, respectively. Median survival is 40 weeks (range 1–114 weeks). Toxicity consisted mainly of moderate to severe myelosuppression, resulting in 2 toxic deaths. The response rate, also for earlier irradiated areas, compares favorably with other known cisplatin-containing regimens. The combination deserves investigation in a randomized setting.