Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples "Federico II" , Naples, Italy.
Academic Unit of Obstetrics and Gynecology, IRCCS AOU San Martino - IST , Genoa, Italy.
Expert Opin Pharmacother. 2020 Apr;21(6):663-677. doi: 10.1080/14656566.2020.1724284. Epub 2020 Feb 8.
Cervical cancer is the fourth common cancer in women worldwide. While, in the past, locally advanced stage disease was treated by pelvic radiotherapy, nowadays the National Cancer Institute strongly recommends chemoradiation protocols. Weekly cisplatin was previously the standard of care in this setting; however, the low response rate and the short median progression-free survival (PFS) of patients have led researchers to investigate combinatory regimens.
This article is based on literature searches up until April 2019, with current trial registers also analyzed. All data available on this topic has been summarized in this narrative review.
In recent years, it has been demonstrated that cisplatin-based doublets, and in particular, cisplatin plus paclitaxel, are superior to cisplatin as a monotherapy in terms of response rate and progression-free survival of patients with advanced cervical cancer. This double regime combined with bevacizumab is also considered the first-line option for metastatic or recurrent disease. Dose-dense paclitaxel in neo-adjuvant chemotherapy combinations is a promising option in patients with locally advanced cervical cancer. Exploration of novel biological therapies and combinations based on the use of paclitaxel is warranted.
宫颈癌是全球女性中第四常见的癌症。虽然过去局部晚期疾病采用盆腔放疗治疗,但如今美国国家癌症研究所强烈推荐放化疗方案。每周顺铂以前是该治疗方案的标准护理方法;然而,患者的低反应率和短的中位无进展生存期(PFS)促使研究人员研究联合治疗方案。
本文基于截至 2019 年 4 月的文献检索,并对当前的试验注册情况进行了分析。该主题的所有可用数据均在这篇叙述性综述中进行了总结。
近年来,已经证明基于顺铂的双药联合治疗,特别是顺铂联合紫杉醇,在晚期宫颈癌患者的反应率和无进展生存期方面优于顺铂单药治疗。该联合方案联合贝伐单抗也被认为是转移性或复发性疾病的一线选择。在局部晚期宫颈癌的新辅助化疗联合中使用紫杉醇的剂量密集方案是一种有前途的选择。有必要探索基于紫杉醇使用的新型生物疗法和联合疗法。