Objective: To evaluate the efficacy and safety of FOLFOX4 (oxaliplatin/5FU/Leucovorin) for the treatment of metastatic cervical cancer. Methods: All patients were designed to receive the FOLFOX4 regimen (Oxaliplatin (Eloxatin <sup>®</sup> ) 85 mg/m 2 D1, 5-Fluorouracil 400 mg/m 2 IV push D1-2, 5-Fluorouracil 600 mg/m 2 IV drip in 22 hours D1-2 and Folinic acid 200 mg/m 2 IV push in D1-2). The treatment responsiveness and toxicities were evaluated. Results: Thirty patients from January 2010-December 2012 were enrolled into the study. The mean age was 51 years old. Nine patients (31%) achieved objective response. At the mean follow-up time of 13 months, the one-year progression-free and overall survival rates were 20.7% and 65.5%, respectively. The most common grade 3 adverse event reported in this study was anemia (36.7%), thrombocytopenia (16.7%) and fatigue (16.7%). Conclusions: FOLFOX4 regimen in metastatic cervical cancer is feasible.
KeywordsCervical CancerFOLFOX4Metastasis
Kamnerdsupaphon, P., Srisukho, S., Sumitsawan, Y., et al. (2008) Cancers in Northern Thailand. Biomedical Imaging and Intervention Journal, 4, e46. http://dx.doi.org/10.2349/biij.4.3.e46
Rose, P.G., Bundy, B.N., Watkins, E.B., et al. (1999) Concurrent Cisplatin-Based Radiotherapy and Chemotherapy for Locally Advanced Cervical Cancer. New England Journal of Medicine, 340, 1144-1153. http://dx.doi.org/10.1056/NEJM199904153401502
Whitney, C.W., Sause, W., Bundy, B., et al. (1999) Randomized Comparison of Fluorouracil plus Cisplatin versus Hydroxyurea as an Adjunct to Radiation Therapy in Stage IIB-IVA Carcinoma of the Cervix with Negative Para-Aortic Lymph Nodes: A Gynecologic Oncology Group and Southwest Oncology Group Study. Journal of Clinical Oncology, 17, 1339-1348.
Morris, M., Eifel, P.J., Lu, J., et al. (1996) Pelvic Radiation with Concurrent Chemotherapy Compared with Pelvic and Para-Aortic Radiation for High-Risk Cervical Cancer. New England Journal of Medicine, 340, 1137-1143. http://dx.doi.org/10.1056/NEJM199904153401501
Omura, G.A. (1996) Chemotherapy for Stage IVB or Recurrent Cancer of the Uterine Cervix. J Natl Cancer Inst Monogr, 21, 123-126.
Moore, D.H., Blessing, J.A., McQuellon, R.P., et al. (2004) Phase III Study of Cisplatin with or without Paclitaxel in Stage IVB, Recurrent, or Persistent Squamous Cell Carcinoma of the Cervix: A Gynecologic Oncology Group Study. Journal of Clinical Oncology, 22, 3113-3119. http://dx.doi.org/10.1200/JCO.2004.04.170
Long 3rd, H.J., Bundy, B.N., Grendys Jr., E.C., et al. (2005) Randomized Phase III Trial of Cisplatin with or without Topotecan in Carcinoma of the Uterine Cervix: A Gynecologic Oncology Group Study. Journal of Clinical Oncology, 23, 4626-4633. http://dx.doi.org/10.1200/JCO.2005.10.021
Monk, B.J., Sill, M.W., McMeekin, D.S., et al. (2009) Phase III Trial of Four Cisplatin-Containing Doublet Combinations in Stage IVB, Recurrent, or Persistent Cervical Carcinoma: A Gynecologic Oncology Group Study. Journal of Clinical Oncology, 27, 4649-4655. http://dx.doi.org/10.1200/JCO.2009.21.8909
Taguchi, T., Tsukagoshi, S., Furue, H., et al. (1998) Phase I Clinical Study of Oxaliplatin. Gan To Kagaku Ryoho, 25, 1899-1907.
Fracasso, P.M., Blessing, J.A., Wolf, J., et al. (2003) Phase II Evaluation of Oxaliplatin in Previously Treated Squamous Cell Carcinoma of the Cervix: A Gynecologic Oncology Group Study. Gynecologic Oncology, 90, 177-180. http://dx.doi.org/10.1016/S0090-8258(03)00253-1
Raymond, E., Chaney, S.G., Taamma, A. and Cvitkovic, E. (1998) Oxaliplatin: A Review of Preclinical and Clinical Studies. Annals of Oncology, 9, 1053-1071. http://dx.doi.org/10.1023/A:1008213732429
Trotti, A., Colevas, A.D., Setser, A., et al. (2003) CTCAE v3.0: Development of a Comprehensive Grading System for the Adverse Effects of Cancer Treatment. Seminars in Radiation Oncology, 13, 176-181. http://dx.doi.org/10.1016/S1053-4296(03)00031-6
Miller, A.B., Hoogstraten, B., Staquet, M. and Winkler, A. (1981) Reporting Results of Cancer Treatment. Cancer, 47, 207-214. http://dx.doi.org/10.1002/1097-0142(19810101)47:1 3.0.CO;2-6
Therasse, P., Arbuck, S.G., Eisenhauer, E.A., et al. (2000) New Guidelines to Evaluate the Response to Treatment in Solid Tumors. Journal of the National Cancer Institute, 92, 205-216. http://dx.doi.org/10.1093/jnci/92.3.205
Kaplan, E.L. and Meier, P. (1958) Non-Parametric Estimation from Incomplete Observations. Journal of the American Statistical Association, 53, 457-481. http://dx.doi.org/10.1080/01621459.1958.10501452
Mantel, N. (1966) Evaluation of Survival Data and Two New Rank Order Statistics Arising in Its Consideration. Cancer Chemotherapy Reports. Part 1, 50, 163-170.
De Gramont, A., Figer, A., Seymour, M., et al. (2000) Leucovorin and Fluorouracil with or without Oxaliplatin as First-Line Treatment in Advanced Colorectal Cancer. Journal of Clinical Oncology, 18, 2938-2947.
Cassidy, J., Tabernero, J., Twelves, C., et al. (2004) XELOX (Capecitabine plus Oxaliplatin): Active First-Line Therapy for Patients with Metastatic Colorectal Cancer. Journal of Clinical Oncology, 22, 2084-2091. http://dx.doi.org/10.1200/JCO.2004.11.069
Goldberg, R.M., Rothenberg, M.L., van Cutsem, E., et al. (2007) The Continuum of Care: A Paradigm for the Management of Metastatic Colorectal Cancer. The Oncologist, 12, 38-50. http://dx.doi.org/10.1634/theoncologist.12-1-38
Alberts, S.R., Townley, P.M., Goldberg, R.M., et al. (2003) Gemcitabine and Oxaliplatin for Metastatic Pancreatic Adenocarcinoma: A North Central Cancer Treatment Group Phase II Study. Annals of Oncology, 14, 580-585. http://dx.doi.org/10.1093/annonc/mdg170
Lorvidhaya, V. (1995) Epirubicin and Cisplatin in Recurrent, Metastatic or Advanced Carcinoma of the Cervix. Gan to Kagaku Ryoho. Cancer & Chemotherapy, 22, 252-255.
Chitapanarux, I., Tonusin, A., Sukthomya, V., Charuchinda, C., Pukanhapan, N. and Lorvidhaya, V. (2003) Phase II Clinical Study of Irinotecan and Cisplatin as First-Line Chemotherapy in Metastatic or Recurrent Cervical Cancer. Gynecologic Oncology, 89, 402-407. http://dx.doi.org/10.1016/S0090-8258(03)00174-4
Kamnerdsupaphon, P., Chitapanarux, I., Tharavichitkul, E., Sukthomya, V. and Lorvidhaya, V. (2009) The Study of Cisplatin and Vinorelbine in Metastatic Uterine Cervical Cancer. Journal of the Medical Association of Thailand, 92, 836-840.
Kuo, D.Y., Blank, S.V., Christos, P.J., et al. (2010) Paclitaxel plus Oxaliplatin for Recurrent or Metastatic Cervical Cancer: A New York Cancer Consortium Study. Gynecologic Oncology, 116, 442-446. http://dx.doi.org/10.1016/j.ygyno.2009.10.082