Chemotherapy with XXXX , @entity1260 , and @entity900 for the treatment of squamous cell cervical cancer: the experience of Monza.

@entity1 @entity137 @entity66 @entity882 @entity5 @entity957 @entity900 @entity1311 @entity1897 @entity1398 @entity1260
The medical treatment of @entity957 is receiving increasing attention. @entity900 and @entity1260 are known effective drugs. @entity1311 has been tested with interesting results in @entity5 . We evaluated the toxic effects and the antitumor activity of a multiagent regimen that included @entity1311 , @entity1260 , and @entity900 (TIP) in two different settings: bulky and locally advanced @entity5 and recurrent-persistent disease. Treatment consisted of @entity1311 175 mg/m2 given over 3 hours on day 1, @entity900 50 mg/m2 (75 mg/m2 in 24 @entity1 ), @entity1260 5 g/m2 and mesna 5 g/m2 given on day 2, and mesna 3 g/m2 given on day 3. In the neoadjuvant setting, the course was repeated every 3 weeks for three courses. Unless there was progression of disease or reason to avoid surgery, all @entity1 were scheduled for radical hysterectomy and pelvic lymphadenectomy. Thirty-eight @entity1 with locally advanced @entity5 were studied: 11 @entity1 achieved a clinical complete response, 21 had a partial response, five had stable disease, and one had disease progression. Among the 34 @entity1 who underwent surgery, six had a pathologically documented complete response, seven had an optimal partial response (only microscopic @entity66 ), 19 had a suboptimal partial response, and two stable diseases. Grade 3-4 @entity1398 was recorded in 71% of @entity1 , grade 3-4 @entity882 in 10.5%, and grade 2 @entity1897 in 2.6%. With a median follow-up period of 22 months for the @entity1 who remain alive, 28 @entity1 are alive without recurrence and five are alive with persistent/recurrent disease. Five @entity1 have died of disease. In the salvage setting, 45 @entity1 with persistent-recurrent disease after primary treatment were treated; 31 of these @entity1 had received prior radiation. In the salvage setting we observed 15 clinical complete responses, 15 partial responses, nine stable diseases, and six disease progressions. The objective response rate was 66.6%. Ten complete responders underwent subsequent surgery and seven had pathologic complete response (two in radiated areas). The response rate was 52% in radiated areas and 75% in nonradiated areas. The median survival time is 6 months for the nonresponders, 9+ month for the partial responders, and 13+ months for the complete responders. The most relevant side effect was myelotoxicity, with 91% of @entity1 experiencing grade 3-4 myelotoxicity. One @entity1 had life-threatening @entity137 . This regimen yields a high response rate with acceptable @entity137 and should be prospectively compared with other regimens. The high rate of pathologic complete and optimal responses might impact positively on survival, but only a longer follow-up period will allow objective assessment of this impact. The specific roles of @entity1311 and @entity1260 in this regimen remain to be fully understood.
