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Efficacy of Modified Dose-dense Paclitaxel in Recurrent Cervical Cancer

Machida, Hiroko, MD*; Moeini, Aida, MD, MPH*; Ciccone, Marcia A., MD*; Mostofizadeh, Sayedamin, MD*; Takiuchi, Tsuyoshi, MD, PhD*; Brunette, Laurie L., MD*; Roman, Lynda D., MD*,†; Matsuo, Koji, MD, PhD*,†

American Journal of Clinical Oncology: September 2018 - Volume 41 - Issue 9 - p 851–860
doi: 10.1097/COC.0000000000000394
Original Articles: Gynecologic

Objective: To examine survival outcomes of women with recurrent cervical cancer who received salvage chemotherapy with modified dose-dense paclitaxel (MDDP) monotherapy (paclitaxel 80 mg/m2, administered on day 1, 8, and 15 without day 22).

Materials and Methods: A retrospective study was conducted to evaluate cause-specific survival after the first recurrence (SAR) of women with recurrent cervical cancer diagnosed between 2006 and 2014. Pooled analyses were performed to examine SAR in women who received MDDP monotherapy (n=17) for any treatment line, compared with those who received salvage chemotherapy with paclitaxel-doublet (n=18) and nonpaclitaxel regimens (n=52).

Results: In the whole cohort, median SAR was 13.7 months including 63 (72.4%) events. MDDP monotherapy regimen was most commonly used in the second-line setting (35.3%) followed by the third/fourth lines (both, 23.5%). Among the women who received MDDP regimen, there were 6 (35.3%) women who received ≥6 cycles; there was 1 (5.9%) women who discontinued the regimen due to adverse effects (grade 3 transaminitis); regimen postponement was seen in 2 (1.4%) of 140 total cycles; and the response rate after the sixth cycle of this regimen was 29.4% (1 complete and 4 partial responses). On univariate analysis, MDDP usage had the highest 2-year SAR rate (MDDP 54.1%, paclitaxel-doublet 43.6%, and nonpaclitaxel regimens 28.1%; P trend=0.044). On multivariate analysis, MDDP monotherapy remained an independent prognostic factor for improved SAR compared with the nonpaclitaxel regimen (adjusted-hazard ratio, 0.50; 95% confidence interval, 0.26-0.95; P=0.036).

Conclusion: Our results suggested that MDDP monotherapy is a tolerable and relatively effective regimen for recurrent cervical cancer.

*Department of Obstetrics and Gynecology, Division of Gynecologic Oncology

Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA

Abstract of the manuscript was presented at 48th Annual Meeting on Womens Cancer, National Harbor, Washington, DC, March 11-15, 2017.

Supported by Ensign Endowment for Gynecologic Cancer Research (K.M.).

The authors declare no conflicts of interest.

Reprints: Koji Matsuo, MD, PhD, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, University of Southern California, 2020 Zonal Avenue IRD520, Los Angeles, CA 90089. E-mail: koji.matsuo@med.usc.edu.

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