Cervical cancer is the fourth most common cancers among women worldwide. Although the cure rates in early-stage disease are good, 30% to 40% of patients in advanced-stage disease ultimately develop locoregional or distal recurrence or both. The prognosis of recurrent cervical carcinoma is very poor, and treatment of such patients remains a challenge. Because of the limited success and significant toxicity with cytotoxic chemotherapy drugs in such subset of patients, interest has grown in EGFR targeted therapeutics. This prospective study defines the role of gefitinib in recurrent or metastatic cervical carcinoma.
The eligible criteria were patients with locoregional recurrence or distant metastasis, not suitable for curative surgery or re-irradiation or for active chemotherapy due to low performance score, patients who developed progression of disease during the salvage chemotherapy; and patients who developed severe toxicity during the course of chemotherapy and therefore could not continue it. Eligible patients were treated with gefitinib at a dose of 250 mg/d orally. It was continued until disease progression or till development of intolerable adverse effects.
A total of 30 patients were enrolled. Median age was 55 years and median disease-free interval was 15 months. Median duration of gefitinib therapy was 6 months. 4 patients had complete response, 8 patient had partial response, 8 patients had stable disease, and 10 patients had progressive disease. None of the patient had severe drug related toxicity.
Gefitinib is tolerated and effective in recurrent or metastatic cervical carcinoma. Further studies are warranted to identify patients who are more likely to benefit from gefitinib.
The authors.
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All authors have declared no conflicts of interest.