Topotecan Use for Second-Line Treatment in Patients with Recurrent or Metastatic Cervical Cancer at Brazilian National Cancer Institute INCAReport as inadecuate




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Objective: Cervical cancer representsthe third most commonly diagnosed cancer and is an important cause of death forwomen suffering with malignancies. Patients who are refractory or progressedafter first-line palliative treatment have a dismal prognosis and nosecond-line chemotherapy is considered standard so far. Several agents havebeen investigated in this setting and topotecan is one of the mostcharacterized. The objective of this study was to evaluate response rate RR,progression-free survival PFS, overall survival OS and toxicity oftopotecan in second palliative line for cervical cancer. Methods: An analysis wasperformed of all patients with recurrent or metastatic cervical cancer treatedwith topotecan in second palliative line at Brazilian National CancerInstitute, between 2008 and 2010. Results: A total of 73 courses of topotecan were given in the current study median:3.5 cycles; range 1 - 6. Anemia was the most frequent adverse event grade 2:35%;grade 3:30%. Of the 20 patients evaluable, there were 2 partial responders tothe treatment. The overall response rate ORR was 10%; 3 patients 15% hadstable disease as maximum response. The median PFS for the entire group was2.93 months 95% CI 2.41 - 3.45 and OS was 4.66 months 95% CI 1.21 - 8.11. Conclusion: The limitedactivity of topotecan schemas in second-line treatment of cervical cancer andthe associated overall toxicity may not justify their use in this setting.Patients who progress after first-line treatment may be offered participationin clinical trials, other second-line agents or best supportive care measures.

KEYWORDS

Topotecan; Cervical Cancer; Palliative Treatment

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L. Oliveira, F. Alves, P. Mora, C. Carmo, A. Nogueira-Rodrigues, A. Garces and A. Melo -Topotecan Use for Second-Line Treatment in Patients with Recurrent or Metastatic Cervical Cancer at Brazilian National Cancer Institute INCA,- Journal of Cancer Therapy, Vol. 4 No. 6, 2013, pp. 1095-1099. doi: 10.4236-jct.2013.46126.





Author: Leandro Nascimento de Oliveira, Flávia Vieira Guerra Alves, Paulo Alexandre Ribeiro Mora, Claudio Calazan do Carmo, Angélica No

Source: http://www.scirp.org/



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