'Encouraging' Long-term Survival Rates for Patients Receiving Neoadjuvant TEP and Surgery for Locally-Advanced Cervical Cancer
(ChemotherapyAdvisor) – Dose reductions are common with neoadjuvant paclitaxel, epirubicin and cisplatin (TEP) for locally advanced cervical cancer (LACC), but TEP has yielded “favorable” overall response rates allowing radical surgery in 71.2% of patients, according to a study published in Gynecologic Oncology.
TEP provided “favorable rates of response and operability in LACC patients,” allowing “encouraging” survival data without excessive toxicity, reported lead author Gabriella Ferrandina, MD, of the Gynecologic Oncology Unit at the Catholic University in Rome, Italy, and coauthors.
A total of 73 patients were evaluated for clinical response, after the administration of neoadjuvant TEP (paclitaxel 175 mg/m2; epirubicin 100 mg/m2; cisplatin 100 mg/m2) on day 1 of 3-weekly cycles, for 2 to 4 cycles, the authors reported.
Complete and partial clinical responses were noted for 13 and 28 patients, respectively (56.1% objective responses), and radical surgery was “amenable” in 52 (71.2%) patients. Overall, median progression-free survival (PFS) was 48 months, with an overall 3-year and 5-year PFS rate (for all patients) of 55% and 51%, respectively. Median OS was 72 months, with an overall 3-year and 5-year OS rate of 58% and 53%, respectively. All 36 patients suffering tumor recurrence or progression, died.
“The rate of operability reported in the whole population (71%) and in the subset of stage IB2/IIB patients (up to 89%) was in the range of values reported in similar series,” the authors reported. They “documented survival data comparable to other studies including poor prognosis features. Moreover, improved survival figures were documented in patients successfully submitted to radical surgery with a 3-year DFS (disease-free survival) and OS (overall survival) of 77.0% and 82.0%, respectively.”
Dose reductions were common, involving 36.5% of patients. Grade 3 leukopenia affected 29.7% of patients and grade 3 neutropenia was noted in 22.9% of patients; 8.1% of patients experienced grade 4 neutropenia. TEP toxicity may have been involved in 1 patient death.
Replacing cisplatin and paclitaxel “with related, less toxic compounds could contribute to further improve the efficacy/toxicity ratio of the triplet,” the authors noted.