Department of Obstetrics and Gynecology, Ludwig-Maximilians-University Munich, Campus Grosshadern, Marchioninistrasse 15, Munich, Germany.
Arch Gynecol Obstet. 2011 Jan;283(1):109-13. doi: 10.1007/s00404-010-1389-1. Epub 2010 Feb 24.
Effective cytotoxic treatment options for advanced cervical cancer are exceedingly limited. Therefore, interest has increased in targeted therapeutics for the treatment of cervical cancer. Cetuximab, a monoclonal antibody, binds specifically to the epidermal growth factor receptor (EGFR) and competitively inhibits the binding of epidermal growth factor and other ligands. In cervical cancer the expression of EGFR is reported in up to 85% of the tumour cells. Therefore, Cetuximab monotherapy could be a new option in the treatment of patients with advanced cervical cancer.
Five patients with advanced cervical cancer were treated with Cetuximab monotherapy as third- to fifth-line therapy between 2005 and 2008 in our institution. The tumour stage at the time of diagnosis ranged between IIB and IVB. Cetuximab was applied with an initial loading dose of 400 mg/m(2) followed by a dose of 250 mg/m(2) weekly.
Only one patient (20%) had a stable disease, and the other four a progressive disease during Cetuximab monotherapy, after the RECIST criteria. Four out of five patients (80%) developed an acneiform rash as a common observed side effect of Cetuximab therapy. The median survival time from the beginning of the Cetuximab therapy was 8.6 months.
No advantage could be found in the treatment with Cetuximab monotherapy in patients with advanced cervical cancer in this study. Further studies are necessary to evaluate the significance of Cetuximab in the treatment of advanced cervical cancer.
晚期宫颈癌有效的细胞毒性治疗选择极为有限。因此,人们对治疗宫颈癌的靶向治疗越来越感兴趣。西妥昔单抗是一种单克隆抗体,特异性结合表皮生长因子受体(EGFR),并竞争性抑制表皮生长因子和其他配体的结合。在宫颈癌中,高达 85%的肿瘤细胞表达 EGFR。因此,西妥昔单抗单药治疗可能是晚期宫颈癌患者治疗的新选择。
在我们机构,2005 年至 2008 年间,有 5 名晚期宫颈癌患者接受西妥昔单抗单药治疗作为三线至五线治疗。诊断时的肿瘤分期在 IIB 期至 IVB 期之间。西妥昔单抗的初始负荷剂量为 400mg/m²,随后每周剂量为 250mg/m²。
根据 RECIST 标准,只有 1 名患者(20%)在西妥昔单抗单药治疗期间病情稳定,其余 4 名患者病情进展。5 名患者中有 4 名(80%)出现痤疮样皮疹,这是西妥昔单抗治疗的常见观察到的副作用。从西妥昔单抗治疗开始到中位生存时间为 8.6 个月。
在这项研究中,在晚期宫颈癌患者中使用西妥昔单抗单药治疗并未发现优势。需要进一步研究来评估西妥昔单抗在治疗晚期宫颈癌中的意义。