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Platinum-free Interval in Second-line Chemotherapy for Recurrent Cervical Cancer

Matoda, Maki MD; Tanigawa, Terumi MD; Omatsu, Kohei MD; Ushioda, Norichika MD; Yamamoto, Akiko MD; Okamoto, Sanshiro MD; Kawamata, Yasutaka MD; Kato, Kazuyoshi MD; Umayahara, Kenji MD; Takeshima, Nobuhiro MD

International Journal of Gynecological Cancer: November 2013 - Volume 23 - Issue 9 - p 1670–1674
doi: 10.1097/IGC.0b013e3182a80a07
Cervical Cancer

Objective: The purpose of this study was to determine whether the platinum-free interval (PFI) was a predictive indicator in second-line treatment of cervical cancer in patients who had undergone prior platinum-based chemotherapy. The role of the PFI in selecting the second-line regimen in other gynecologic malignancies is also discussed.

Methods: In this retrospective study, we examined the clinical records of patients with recurrent or metastatic cervical cancer who had received platinum-containing combination regimens as second-line chemotherapy. All patients had received prior platinum-containing chemotherapy or concurrent chemoradiotherapy.

Results: The overall response rate to second-line chemotherapy was 25.8%; 7 patients achieved a complete response and 17 a partial response. The median progression-free survival (PFS) was 5.1 months and median overall survival (OS) was 13.5 months. The response rate was 12.5%, 14.2%, 20.0%, 22.2%, and 55.0%; median PFS was 4.0, 5.1, 4.4, 5.8, and 7.4 months; and median OS was 10.2, 14.4, 11.9, 16.3, and 19.7 months when PFI was within 3, 3 to 5, 6 to 11, 12 to 23, and more than 24 months, respectively. Age (>50 years), size (>3 cm), prior radiotherapy, and PFI (>24 months) were identified as prognostic factors in the multivariate analysis for PFS and OS.

Conclusions: The results indicate that a PFI of more than 24 months is the discriminating point between platinum-sensitive and platinum-resistance cervical cancer. This indicates that PFI offers a useful tool in selecting agents for second-line chemotherapy in a wide range of gynecologic malignancies.

Department of Gynecology, Cancer Institute Hospital, Tokyo, Japan.

Address correspondence and reprint requests to Maki Matoda, MD, Department of Gynecology, Cancer Institute Hospital, Ariake 3-8-31, Koutou-ku, Tokyo, 135-8550, Japan. E-mail: maki.matsumura@jfcr.or.jp.

The authors declare no conflicts of interest.

Received June 11, 2013

Accepted August 4, 2013

© 2013 by the International Gynecologic Cancer Society and the European Society of Gynaecological Oncology.