Chemotherapy for Recurrent Cervical Cancer
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Questions and Answers

What was the overall response rate reported for the chemotherapy treatment?

  • 40.2% (correct)
  • 21%
  • 73%
  • 15.4%
  • Which group had the highest complete response rate?

  • Patients with extrapelvic disease
  • Patients with isolated chest disease (correct)
  • Patients with isolated lung metastases
  • Patients with pelvic disease recurrence
  • In the Gynecologic Oncology Group study, what was the response rate for the 100 mg/m2 cisplatin regimen?

  • 31.4% (correct)
  • 25.0%
  • 20.7%
  • 15.4%
  • Which drug was compared with doxorubicin in the trial for recurrent squamous cell cervix carcinoma?

    <p>Vincristine (B)</p> Signup and view all the answers

    What significant finding was noted regarding the location of recurrence in terms of survival?

    <p>It did not significantly alter survival. (C)</p> Signup and view all the answers

    What was the reported response rate for vinblastine in previously treated patients with squamous carcinoma of the cervix?

    <p>49% (C)</p> Signup and view all the answers

    In the study combining cisplatin and 5-fluorouracil, what was the median survival duration reported?

    <p>6.4 months (D)</p> Signup and view all the answers

    What percentage of patients experienced partial responses when treated with continuous-infusion vinblastine?

    <p>10% (A)</p> Signup and view all the answers

    What was the objective response rate among patients treated with prolonged oral etoposide?

    <p>54% (A)</p> Signup and view all the answers

    What was the typical median duration of response for patients treated with single-agent chemotherapy of oral etoposide?

    <p>3.5 months (A)</p> Signup and view all the answers

    What was the primary focus of the Phase II studies mentioned?

    <p>Efficacy of various drug treatments for advanced cervical and other cancers (B)</p> Signup and view all the answers

    Which chemotherapy drugs were assessed together in the studies?

    <p>Adriamycin and cyclophosphamide (C)</p> Signup and view all the answers

    Which phase II study focused on patients with recurrent squamous cell carcinoma of the cervix?

    <p>Study of continuous-infusion vinblastine (B)</p> Signup and view all the answers

    What type of cancer was included in the clinical screening group study of pirarubicin?

    <p>Endometrial cancer (D)</p> Signup and view all the answers

    Which study involved the use of mitoxantrone for the treatment of cervical carcinoma?

    <p>Gynecologic Oncology Group study (C)</p> Signup and view all the answers

    Which chemotherapy agent was evaluated for its continuous infusion method?

    <p>Vinblastine (D)</p> Signup and view all the answers

    What was the outcome measured in the studies focusing on advanced cancers?

    <p>Efficacy of drug combinations (D)</p> Signup and view all the answers

    What was the common patient characteristic across the Phase II studies mentioned?

    <p>Patients with metastatic cancer (C)</p> Signup and view all the answers

    Which combination has been shown to improve overall survival in patients with advanced squamous cell carcinoma of the cervix?

    <p>Cisplatin and topotecan (B)</p> Signup and view all the answers

    What treatment combination yielded superior response rates without diminishing patient quality of life?

    <p>Topotecan and paclitaxel with cisplatin (C)</p> Signup and view all the answers

    What is the primary focus of the currently active GOG 0204 trial?

    <p>To compare various agents when combined with cisplatin (B)</p> Signup and view all the answers

    Why is it important to identify clinical and tumor-related factors predictive of non-response to cisplatin-based chemotherapy?

    <p>To identify candidates for non platinum-containing regimens (C)</p> Signup and view all the answers

    What did the studies indicate about the combination of topotecan and paclitaxel in relation to progression-free survival?

    <p>It improved progression-free survival (A)</p> Signup and view all the answers

    Which of the following agents are mentioned as candidates for comparison in future trials alongside cisplatin?

    <p>Topotecan and vinorelbine (B)</p> Signup and view all the answers

    What effect does the combination of topotecan, paclitaxel, and cisplatin have on patient quality of life?

    <p>Has no effect on patient quality of life (D)</p> Signup and view all the answers

    Which class of drugs was not mentioned as being tested in combination with cisplatin for cervical cancer treatment?

    <p>Tyrosine kinase inhibitors (C)</p> Signup and view all the answers

    Which drug was studied in a phase II trial for treating advanced squamous cell carcinoma of the cervix?

    <p>Irinotecan (D)</p> Signup and view all the answers

    What was the focus of the Gynecologic Oncology Group study mentioned in 1989?

    <p>Chemotherapy dose comparison (C)</p> Signup and view all the answers

    Which drug combination was researched for the treatment of advanced squamous cell carcinoma of the cervix in the 1999 clinical trial?

    <p>Cisplatin and 5-Fluorouracil (A)</p> Signup and view all the answers

    What was the outcome of the phase II study involving vindesine for recurrent uterine cervix cancer?

    <p>Limited efficacy in treatment (D)</p> Signup and view all the answers

    In the 1981 study, what type of cancer was the subject of investigation involving high doses of a chemotherapy agent?

    <p>Squamous cell carcinoma of the cervix (B)</p> Signup and view all the answers

    Which chemotherapy agent was highlighted in the 1986 study for its use in metastatic cancer of the cervix?

    <p>Vincristine (C)</p> Signup and view all the answers

    What type of trial was conducted in 1997 evaluating irinotecan for cervix cancer treatment?

    <p>Phase II study (A)</p> Signup and view all the answers

    Which of the following was a comparison made in a Gynecologic Oncology Group study regarding cisplatin in 1989?

    <p>Fast versus slow infusion (C)</p> Signup and view all the answers

    What percentage of patients had a complete response to the initial chemotherapy?

    <p>60% (B)</p> Signup and view all the answers

    Which of the following drugs was mentioned in the Phase II trials for treating recurrent cervix cancer?

    <p>Topotecan (D)</p> Signup and view all the answers

    How many assessable patients were involved in the initial chemotherapy results?

    <p>10 (A)</p> Signup and view all the answers

    What type of therapy is being tested in combination with chemotherapy in ongoing trials for cervix cancer?

    <p>Targeted therapy (C)</p> Signup and view all the answers

    Of the patients who did not have a complete response, what percentage achieved a partial response?

    <p>20% (C)</p> Signup and view all the answers

    Which of the following studies is focused on carboplatin for recurrent cervix cancer?

    <p>Weiss et al. study (D)</p> Signup and view all the answers

    What is the purpose of ongoing phase II trials mentioned in the content?

    <p>To investigate the effects of targeted therapies (A)</p> Signup and view all the answers

    What type of cancer is being primarily discussed in the content?

    <p>Cervical cancer (C)</p> Signup and view all the answers

    Study Notes

    Chemotherapy for Recurrent Cervical Cancer

    • Cervical cancer is the second most common cancer in women worldwide, and a leading cause of death in young women. Recurrent rates range from 10-20% for stages Ib-IIa, and 50-70% for locally advanced cases (IIb-IVa).
    • Single-agent cisplatin remains the standard therapy for advanced, persistent, or recurrent cervical cancer. While other single agents have been tested, none have proven superior to cisplatin.
    • Combinations of cisplatin and topotecan, or paclitaxel, show improved response rates and progression-free survival without impacting patient quality of life. Only the combination of cisplatin and topotecan has improved overall survival.
    • Identifying factors that predict response to cisplatin-based chemotherapy is crucial.
    • Future research should investigate combining biological agents (monoclonal antibodies or small molecules) with chemotherapy to improve treatment outcomes for advanced, persistent, or recurrent cervical cancer.
    • Chemotherapy in recurrent or metastatic disease is primarily palliative.
    • Cisplatin administered every three weeks is a common approach, often resulting in response rates of 20-30% and a median survival of 7 months.
    • Re-treatment for recurrent cancer is determined by patient factors such as prior treatment, site/extent, disease-free interval, and performance status.

    Single-Agent Chemotherapy

    • Response to chemotherapy is limited in recurrent cervical carcinoma.
    • Factors affecting response include the limited sensitivity of irradiated pelvic tumors, usually a 3-7 month median response, difficulty improving overall survival, and high rates of treatment failure.
    • Platinum-based and non-platinum-based therapies are subdivided into groups.
    • Cisplatin has shown activity in squamous cell carcinoma of the cervix, with reported response rates varying from 17-21%.
    • Higher doses of cisplatin have not improved survival, but lower doses may show less toxicity.

    Combination Chemotherapy

    • Combining chemotherapy agents can potentially enhance response rates and survival time.
    • Studies have explored combinations of cisplatin with other drugs, such as 5-fluorouracil, bleomycin, ifosfamide, gemcitabine, vinorelbine, paclitaxel, and topotecan for better treatment outcomes.
    • Some combinations, particularly cisplatin and topotecan, demonstrate improved overall survival compared to cisplatin alone.
    • Triplets, or combinations of three chemotherapeutic agents, are frequently studied with variable success.
    • Research continues on combining these drugs to enhance results.

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    Description

    This quiz explores the latest advancements and treatment protocols for recurrent cervical cancer. It focuses on the efficacy of cisplatin and its combinations, as well as the importance of predicting treatment responses. Gain insights into ongoing research aimed at enhancing patient outcomes in cervical cancer therapy.

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