Researchers at Shizuoka Cancer Center Hospital in Japan recently revealed that important concepts and prognostic factors on ovarian cancer can also be applied to cervical cancer. The study was published in the Journal of Gynecologic Oncology and is entitled “Platinum sensitivity and non-cross-resistance of cisplatin analogue with cisplatin in recurrent cervical cancer”.
Cervical cancer is the third most commonly diagnosed cancer in women. It is characterized by an abnormal cell growth in the cervix, the lower part of the uterus. Cervical cancer can be successfully treated when detected at an early stage, usually through a Papanicolaou (Pap) smear test, where the doctor scrapes a small sample of cervical cells to look for abnormal cell changes. The majority of all cervical cancer cases are caused by the human papillomavirus (HPV), which can be transmitted by sexual contact. It is estimated that in 2015, 12,900 new cases of cervical cancer will be diagnosed in the United States resulting in 4,100 deaths.
Chemotherapy is a treatment option for advanced or recurrent cervical cancer, with the chemotherapeutic agent cistaplin, a platinum-containing anti-cancer drug, considered one of the most potent antitumor agents with a response rate of 38%. Cistaplin acts by binding to DNA and activating several molecular pathways that ultimately lead to apoptosis (cell death).
In ovarian cancer, one of the most important prognostic factors in recurrence is the platinum free interval (PFI), meaning the period between the completion of a platinum-based primary chemotherapy and tumor recurrence. Women with a recurrent ovarian cancer and a PFI of more than 6 months are considered platinum sensitive.
In the study, researchers conducted a retrospective analysis to assess the hypothesis that PFI can affect treatment efficacy of second-line platinum-based chemotherapy in patients with recurrent cervical cancer who had been previously treated with cisplatin-based chemotherapy. The team believes that the concept of platinum sensitivity can also be applicable in recurrent cervical cancer cases. Furthermore, the concept of non-cross-resistance of cisplatin analogue (e.g. carboplatin) with cisplatin in recurrent cervical cancer was assessed.
In total, the team analyzed 49 patients (median age of 53 years) and found that the patients’ rate of response to second-line platinum-based chemotherapy had a strong correlation with PFI, which became higher when PFI was superior to 12 months, influencing not only the response rate to second-line chemotherapy, but also the progression-free survival and overall survival. These results suggested that a PFI of 12 months could be used as a predictor of second-line chemotherapy response rate and survival in patients with recurrent cervical cancer initially treated with cisplatin.
Researchers demonstrated that non-cross-resistance of cisplatin analogue with cisplatin can occur in cervical cancer, since the team found a statistically significant difference in progression-free survival in patients with a PFI of less than 6 months when they were re-administered cisplatin (3.0 months) or administered a cisplatin analogue (7.2 months) as second-line chemotherapy. These findings led the team to suggest that patients with recurrent cervical cancer and previous cisplatin administration should be given a second-line chemotherapy cisplatin analogue-based treatment.
The authors concluded that the concept of platinum sensitivity could be applied to recurrent cervical cancer, however further studies should be conducted to confirm these results.