Top

International Journal of Clinical Oncology

Published in:

01-12-2016 | Original Article

Neoadjuvant chemotherapy with docetaxel and carboplatin followed by radical hysterectomy for stage IB2, IIA2, and IIB patients with non-squamous cell carcinoma of the uterine cervix

Authors: Muneaki Shimada, Shoji Nagao, Keiichi Fujiwara, Nobuhiro Takeshima, Ken Takizawa, Tadahiro Shoji, Toru Sugiyama, Satoshi Yamaguchi, Ryuichiro Nishimura, Junzo Kigawa

Published in: International Journal of Clinical Oncology | Issue 6/2016

Abstract

Background

We conducted a phase II study to evaluate the efficacy of neoadjuvant chemotherapy with docetaxel and carboplatin followed by radical hysterectomy for patients with non-squamous cell carcinoma of the uterine cervix.

Methods

Sixty-one patients with International Federation of Gynecology and Obstetrics stage IB2, IIA2, or IIB non-squamous cell carcinoma of the uterine cervix were enrolled. The patients were administered docetaxel at a dose of 60 mg/m², followed by carboplatin at a dose based on an area under the curve of 6. The treatments were repeated every 21 days for one to three cycles. Fifty-two patients were eligible to evaluate the efficacy of neoadjuvant chemotherapy followed by radical hysterectomy. Adverse events were evaluated in 59 patients.

Results

The response rate was 69 % (95 % CI, 57–82 %), with 5 patients achieving complete response, 31 partial response, 15 stable disease, and 1 progressive disease. Median follow-up duration was 1913 days with a range of 145–2632 days. Of 52 patients, 50 underwent radical hysterectomy after neoadjuvant chemotherapy. The 2-year overall survival rate was 81.8 % for stage IB2, 85.7 % for stage IIA2, and 92.6 % for stage IIB. The most frequent grade 3 and 4 hematological toxicity was neutropenia, with 43 patients experiencing grade 4 and 11 with grade 3. The nonhematological toxicities were mainly grade 1 or 2 in severity.

Conclusion

Neoadjuvant chemotherapy with docetaxel and carboplatin followed by radical hysterectomy may be a useful strategy for patients with non-squamous cell carcinoma of uterine cervix.

Smith HO, Tiffany MF, Qualls CR et al (2000) The rising incidence of adenocarcinoma relative to squamous cell carcinoma of the uterine cervix in the United States—a 24-year population-based study. Gynecol Oncol 78:97–105CrossRefPubMed

Irie T, Kigawa J, Minagawa Y et al (2000) Prognosis and clinicopathological characteristics of Ib-IIb adenocarcinoma of the uterine cervix in patients who have had radical hysterectomy. Eur J Surg Oncol 26:464–467CrossRefPubMed

Galic V, Herzog TJ, Lewin SN et al (2012) Prognostic significance of adenocarcinoma histology in women with cervical cancer. Gynecol Oncol 125:287–291CrossRefPubMed

Quinn MA, Benedet JL, Odicino F et al (2006) Carcinoma of the cervix uteri. FIGO 26th annual report on the results of treatment in gynecological cancer. Int J Gynaecol Obstet 95:S43–S103CrossRefPubMed

Wright AA, Howitt BE, Myers AP et al (2013) Oncogenic mutations in cervical cancer: genomic differences between adenocarcinoma and squamous cell carcinoma of the cervix. Cancer (Phila) 119:3776–3783CrossRef

Tewari KS, Sill MW, Long HJ 3rd et al (2014) Improved survival with bevacizumab in advanced cervical cancer. N Engl J Med 370:734–743CrossRefPubMedPubMedCentral

NCCN Clinical Practice Guideline in Oncology (NCCN Guidelines) Version 2 (2015) Cervical cancer. http://www.nccn.org/professionals/physician_gls/f_guidelines.asp. Accessed 1 Mar 2015

Landoni F, Maneo A, Colombo A et al (1997) Randomised study of radical surgery versus radiotherapy for stage Ib–IIa cervical cancer. Lancet 350:535–540CrossRefPubMed

Niibe Y, Kenjo M, Onishi H et al (2010) High-dose-rate intracavitary brachytherapy combined with external beam radiotherapy for stage IIIb adenocarcinoma of the uterine cervix in Japan: a multi-institutional study of Japanese Society of Therapeutic Radiology and Oncology 2006–2007 (study of JASTRO 2006–2007). Jpn J Clin Oncol 40:795–799CrossRefPubMed

10.

Huang YT, Wang CC, Tsai CS et al (2011) Long-term outcome and prognostic factors for adenocarcinoma/adenosquamous carcinoma of cervix after definitive radiotherapy. Int J Radiat Oncol Biol Phys 80:429–436CrossRefPubMed

11.

Mikami M, Aoki Y, Sakamoto M et al (2014) Disease Committee of Uterine Cervical and Vulvar Cancer, Japanese Gynecologic Oncology Group. Surgical principles for managing stage IB2, IIA2, and IIB uterine cervical cancer (bulky tumors) in Japan: a survey of the Japanese Gynecologic Oncology Group. Int J Gynecol Cancer 24:1333–1340CrossRefPubMed

12.

Eddy GL, Bundy BN, Creasman WT et al (2007) Treatment of (“bulky”) stage IB cervical cancer with or without neoadjuvant vincristine and cisplatin prior to radical hysterectomy and pelvic/para-aortic lymphadenectomy: a phase III trial of the Gynecologic Oncology Group. Gynecol Oncol 106:362–369CrossRefPubMed

13.

Neoadjuvant Chemotherapy for Locally Advanced Cervical Cancer Meta-analysis Collaboration (2003) Neoadjuvant chemotherapy for locally advanced cervical cancer: a systematic review and meta-analysis of individual patient data from 21 randomised trials. Eur J Cancer 39:2470–2486CrossRef

14.

Rydzewska L, Tierney J, Vale CL et al (2012) Neoadjuvant chemotherapy plus surgery versus surgery for cervical cancer. Cochrane Database Syst Rev 12:CD007406PubMed

15.

Kim HS, Sardi JE, Katsumata N et al (2013) Efficacy of neoadjuvant chemotherapy in patients with FIGO stage IB1 to IIA cervical cancer: an international collaborative meta-analysis. Eur J Surg Oncol 39:115–124CrossRefPubMed

16.

Takekida S, Fujiwara K, Nagao S et al (2010) Phase II study of combination chemotherapy with docetaxel and carboplatin for locally advanced or recurrent cervical cancer. Int J Gynecol Cancer 20:1563–1568PubMed

17.

Rose PG, Java JJ, Whitney CW et al (2014) Locally advanced adenocarcinoma and adenosquamous carcinomas of the cervix compared to squamous cell carcinomas of the cervix in Gynecologic Oncology Group trials of cisplatin-based chemoradiation. Gynecol Oncol 135:208–212CrossRefPubMedPubMedCentral

18.

Lee JY, Kim YT, Kim S et al (2015) Prognosis of cervical cancer in the era of concurrent chemoradiation from national database in Korea: a comparison between squamous cell carcinoma and adenocarcinoma. PLoS One doi:10.1371/journal.pone.0144887

19.

Iwasaka T, Fukuda K, Hara K et al (1998) Neoadjuvant chemotherapy with mitomycin C, etoposide, and cisplatin for adenocarcinoma of the cervix. Gynecol Oncol 70:236–420CrossRefPubMed

20.

Lissoni A, Gabriele A, Gorga G et al (1997) Cisplatin-, epirubicin- and paclitaxel-containing chemotherapy in uterine adenocarcinoma. Ann Oncol 8:969–972CrossRefPubMed

21.

Saito T, Takehara M, Lee R et al (2004) Neoadjuvant chemotherapy with cisplatin, aclacinomycin A, and mitomycin C for cervical adenocarcinoma—a preliminary study. Int J Gynecol Cancer 14:483–490CrossRefPubMed

22.

Yessaian A, Magistris A, Burger RA et al (2004) Radical hysterectomy followed by tailored postoperative therapy in the treatment of stage IB2 cervical cancer: feasibility and indications for adjuvant therapy. Gynecol Oncol 94:61–66CrossRefPubMed

23.

Deura I, Shimada M, Hirashita K et al (2015) Incidence and risk factors for lower limb lymphedema after gynecologic cancer surgery with initiation of periodic complex decongestive physiotherapy. Int J Clin Oncol 20:556–560CrossRefPubMed

24.

Hosaka M, Watari H, Takeda M et al (2008) Treatment of cervical cancer with adjuvant chemotherapy versus adjuvant radiotherapy after radical hysterectomy and systematic lymphadenectomy. J Obstet Gynecol Res 34:552–556CrossRef

25.

Shimada M, Kigawa J, Takahashi M et al (2004) Stromal invasion of the cervix can be excluded from the criteria using adjuvant radiotherapy following radical surgery for patients with cervical cancer. Gynecol Oncol 93:628–631CrossRefPubMed

26.

Matsumura M, Takeshima N, Ota T et al (2010) Neoadjuvant chemotherapy followed by radical hysterectomy plus postoperative chemotherapy but no radiotherapy for stage IB2–IIB cervical cancer: irinotecan and platinum chemotherapy. Gynecol Oncol 119:212–216CrossRefPubMed

27.

Hosaka M, Watari H, Kato T et al (2012) Clinical efficacy of paclitaxel/cisplatin as an adjuvant chemotherapy for patients with cervical cancer who underwent radical hysterectomy and systematic lymphadenectomy. J Surg Oncol 105:612–616CrossRefPubMed

28.

Nakanishi T, Ishikawa H, Suzuki Y et al (2000) A comparison of prognoses of pathologic stage Ib adenocarcinoma and squamous cell carcinoma of the uterine cervix. Gynecol Oncol 79:289–293CrossRefPubMed

29.

Park JY, Kim DY, Kim JH et al (2010) Outcomes after radical hysterectomy in patients with early-stage adenocarcinoma of uterine cervix. Br J Cancer 102:1692–1698CrossRefPubMedPubMedCentral

30.

Kasamatsu T, Onda T, Sawada M et al (2009) Radical hysterectomy for FIGO stage I–IIB adenocarcinoma of the uterine cervix. Br J Cancer 100:1400–1405CrossRefPubMedPubMedCentral

31.

Shimada M, Nishimura R, Nogawa T et al (2013) Comparison of the outcome between cervical adenocarcinoma and squamous cell carcinoma patients with adjuvant radiotherapy following radical surgery: SGSG/TGCU intergroup surveillance. Mol Clin Oncol 1:780–784PubMedPubMedCentral

32.

Eifel PJ, Burke TW, Morris M et al (1995) Adenocarcinoma as an independent risk factor for disease recurrence in patients with stage IB cervical carcinoma. Gynecol Oncol 59:38–44CrossRefPubMed

33.

Shimada M, Kigawa J, Nishimura R et al (2006) Ovarian metastasis in carcinoma of the uterine cervix. Gynecol Oncol 101:234–237CrossRefPubMed

Title: Neoadjuvant chemotherapy with docetaxel and carboplatin followed by radical hysterectomy for stage IB2, IIA2, and IIB patients with non-squamous cell carcinoma of the uterine cervix
Authors: Muneaki Shimada
Shoji Nagao
Keiichi Fujiwara
Nobuhiro Takeshima
Ken Takizawa
Tadahiro Shoji
Toru Sugiyama
Satoshi Yamaguchi
Ryuichiro Nishimura
Junzo Kigawa
Publication date: 01-12-2016
Publisher: Springer Japan
Published in: International Journal of Clinical Oncology / Issue 6/2016
Print ISSN: 1341-9625
Electronic ISSN: 1437-7772
DOI: https://doi.org/10.1007/s10147-016-1010-0

Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras

Prof. Fabrice Barlesi

Developed by: Springer Medicine

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 6/2016

Intrathoracic extensive-stage small cell lung cancer: assessment of the benefit of thoracic and brain radiotherapy using the SEER database

Current status of systemic chemotherapy for octogenarians with advanced urothelial cancer in Japan: a Japanese multi-institutional study (CURE study)

A survey on fertility management in young women of reproductive age treated with chemotherapy

CpG island methylator phenotype is associated with the efficacy of sequential oxaliplatin- and irinotecan-based chemotherapy and EGFR-related gene mutation in Japanese patients with metastatic colorectal cancer

Microdissection testicular sperm extraction in Japanese patients with persistent azoospermia after chemotherapy

Factors predicting efficacy and adverse effects of enzalutamide in Japanese patients with castration-resistant prostate cancer: results of retrospective multi-institutional study

Keynote webinar | Spotlight on antibody–drug conjugates in cancer