Carboplatin and paclitaxel for advanced and recurrent cervical carcinoma: the British Columbia Cancer Agency experience

Background. One of the most active chemotherapy combinations in advanced or recurrent cervical cancer is cisplatin–paclitaxel. However, this palliative regimen is associated with significant toxicity. Carboplatin–paclitaxel is thus an attractive option. Methods. Patients with advanced or recurrent carcinoma of the cervix treated with carboplatin–paclitaxel from April 2000 were included in the study. Starting doses of carboplatin–paclitaxel were: AUC 5–6 and 155–175 mg/m2, respectively, repeated every 28 days. Results. Twenty-five women treated with this combination were identified. Twenty-three women (92%) had prior treatment with pelvic radiotherapy and 14 (56%) had had concurrent radio-sensitizing cisplatin. There was a 20% PR and a 20% CR rate (10/25). The median progression-free survival for the entire group was 3 months. Responders had a median PFS of 16 months. Fourteen patients (56%) had died of disease progression. The median overall survival (OS) was 21 months. Common toxicities included: grade 1 or 2 anemia, 68%; grade 3 or 4 anemia, 32%; grade 3 or 4 neutropenia, 32%; and grade 1 or 2 peripheral neuropathy, 24%. ECOG PS did not change significantly while on treatment. Eighty-four percent of treatments were delivered on time, and 96% at full dose. Conclusions. Carboplatin–paclitaxel is an active combination in advanced and recurrent cervical cancer. In this predominantly pre-irradiated group, the combination was deliverable, well tolerated, and the most commonly observed toxicity was anemia.