TITLE:
Topotecan Use for Second-Line Treatment in Patients with Recurrent or Metastatic Cervical Cancer at Brazilian National Cancer Institute (INCA)
AUTHORS:
Leandro Nascimento de Oliveira, Flávia Vieira Guerra Alves, Paulo Alexandre Ribeiro Mora, Claudio Calazan do Carmo, Angélica Nogueira-Rodrigues, Alvaro Henrique Ingles Garces, Andréia Cristina de Melo
KEYWORDS:
Topotecan; Cervical Cancer; Palliative Treatment
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.4 No.6,
July
24,
2013
ABSTRACT: Objective: Cervical cancer represents
the third most commonly diagnosed cancer and is an important cause of death for
women suffering with malignancies. Patients who are refractory or progressed
after first-line palliative treatment have a dismal prognosis and no
second-line chemotherapy is considered standard so far. Several agents have
been investigated in this setting and topotecan is one of the most
characterized. The objective of this study was to evaluate response rate (RR),
progression-free survival (PFS), overall survival (OS) and toxicity of
topotecan in second palliative line for cervical cancer. Methods: An analysis was
performed of all patients with recurrent or metastatic cervical cancer treated
with topotecan in second palliative line at Brazilian National Cancer
Institute, between 2008 and 2010. Results: A total of 73 courses of topotecan were given in the current study (median:
3.5 cycles; range 1 - 6). Anemia was the most frequent adverse event (grade 2:35%;
grade 3:30%). Of the 20 patients evaluable, there were 2 partial responders to
the treatment. The overall response rate (ORR) was 10%; 3 patients (15%) had
stable disease as maximum response. The median PFS for the entire group was
2.93 months (95% CI 2.41 - 3.45) and OS was 4.66 months (95% CI 1.21 - 8.11). Conclusion: The limited
activity of topotecan schemas in second-line treatment of cervical cancer and
the associated overall toxicity may not justify their use in this setting.
Patients who progress after first-line treatment may be offered participation
in clinical trials, other second-line agents or best supportive care measures.