VEGF and Cervical Cancer Stage IB – IIA Response after Chemotherapy with Ifosfamide – Cisplatin

The aim of this study is to evaluate response of cervical cancer stage IB – IIA after neoadjuvant chemotherapy based on VEGF expression. The data were collected from 51 patients’ cervical cancer stage IB – IIA parafin blocks who received chemotherapy ifosfamide – cisplatin before radical hysterectomy at General Hospital Adam Malik Medan. VEGF expression was evaluated from cervical biopsy tissue, and response therapy was evaluated based on tumor size clinically. 20 out of 51 samples with clinically complete response, and the rest are partial response. 18 out of 20 samples with clinically complete response have negative or weak VEGF expression, and 31 out of 51 samples patients were partialy response with moderate or strong VEGF expression. 23 cases with tumor size > 4 cm and 23 cases stage IIA expressed VEGF moderately or strong. Cervical cancer with tumor size < 4 cm and cervical cenncer stage IB with less expressed of VEGF have good response with chemotherapy adjuvant ifosfamide – cis platin.Keyword: ifosfamide-cisplatin, cervical cancer, VEGF

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Relationships between Histopathology Type and Neoadjuvant Chemotherapy Response for Cervical Cancer Stage IB2 and IIA2

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2020.4019 ◽

2020 ◽

Vol 8 (B) ◽

pp. 507-513

Author(s):

Syamel Muhammad ◽

Jamsari Jamsari ◽

Netti Suharti ◽

Yudi Mulyana Hidayat ◽

Gistin Husnul Khatimah

Keyword(s):

Cervical Cancer ◽

Neoadjuvant Chemotherapy ◽

Chemotherapy Resistance ◽

Transrectal Ultrasound ◽

Evaluation Criteria ◽

Complete Response ◽

Chemotherapy Response ◽

Cancer Stage ◽

Therapy Strategy ◽

Definitive Therapy

BACKGROUND: Cervical cancer was the fourth common women cancer in the world and the second most in Indonesia. Chemotherapy has been evaluated as a therapy strategy to treat cervical cancer stage IB2 and IIA2 prior the radical hysterectomy. Neoadjuvant chemotherapy was still being a controversy for the chemotherapy resistance patient and will delay the definitive therapy. A marker is needed to identify patient which more relatively resistant to chemotherapy. Squamous cell carcinoma (SCC) type was known to have a better response to neoadjuvant chemotherapy than non-SCC (nSCC) type, but they are no studies at Dr. M. Djamil Padang General Hospital yet on this matter before. OBJECTIVE: The objectives of the study were to obtain the relationship between histopathology type and neoadjuvant chemotherapy response for cervical cancer stage IB2 and IIA2. METHODS: This cohort analytic study conducted at Dr. M Djamil Padang Hospital which obtained 35 samples of stage IB2 and IIA2 cervical cancer patients whom treated with neoadjuvant chemotherapy. Results of histopathology are based on biopsy at diagnosis done for cervical cancer and chemotherapy response is based on transrectal ultrasound examinations before and after given neoadjuvant chemotherapy with response evaluation criteria in solid tumors criteria. RESULTS: Complete response and partial response in the SCC and nSCC group were 32%–50%, while stable disease (SD) and progressive disease were 68% in the SCC group to 50% in the nSCC group. CONCLUSION: There was no significant relationship between histopathological type and neoadjuvant chemotherapy response for cervical cancer stage IB2 and IIA2 (p = 0.44).

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Comparative study of chemoradiation and neoadjuvant chemotherapy effects before radical hysterectomy in stage IB–IIB bulky cervical cancer and with tumor diameter greater than 4 cm

International Journal of Gynecological Cancer ◽

10.1136/ijgc-00009577-200505000-00011 ◽

2005 ◽

Vol 15 (3) ◽

pp. 483-488

Author(s):

M. Modarress ◽

F. Q. Maghami ◽

M. Golnavaz ◽

N. Behtash ◽

A. Mousavi ◽

...

Keyword(s):

Cervical Cancer ◽

Neoadjuvant Chemotherapy ◽

Radical Hysterectomy ◽

Tumor Size ◽

Pathologic Complete Response ◽

Residual Tumor ◽

Preoperative Treatment ◽

Tumor Diameter ◽

Stage Ib ◽

Significant Difference

Tumor size seems to be a determinant in the prognosis of early cervical cancer. Patients with tumor greater than 4 cm (bulky) in diameter have worse outcome. The purpose of this study was to compare the efficacy of preoperative combined chemoradiation and neoadjuvant chemotherapy (NAIC) programs followed by radical hysterectomy in stage IB–IIB bulky cervical cancer. From September 1999 to April 2002, 60 patients with stage IB–IIB bulky cervical cancer were treated with preoperative external-beam radiotherapy to 45 Gy plus weekly cisplatin 50 mg/m2 or preoperative NAIC by cisplatin 50 mg/m2 and vincristin 1 mg/m2 every 7–10 days, for three courses. Surgery was performed 4–6 weeks after the completion of the preoperative treatment. There were no significant difference between age, stage, tumor size, and histopathologic type in two groups (P > 0.05). Toxicity associated with two treatment methods was usually mild. In chemoradiation group, two patients developed vesicovaginal fistula, and four patients developed long-term hydronephrosis that needed urethral stenting. Before surgery, complete and partial clinical response had no significant difference between two groups (P > 0.05). After surgery, lymph node and parametrial involvement had no significant difference between two groups (P > 0.05). In NAIC group, more patients had significantly residual tumor (P = 0.012), but residual tumor size had no significant difference between two groups (P > 0.05). Pathologic complete response was significantly higher in chemoradiation group (P = 0.004). According to the result of this study, it seems that NAIC and chemoradiation had similar effects in survival prognostic factors.

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Combination of weekly paclitaxel-carboplatin plus standard bevacizumab as neoadjuvant treatment in stage IB–IIB cervical cancer

International Journal of Gynecological Cancer ◽

10.1136/ijgc-2021-002432 ◽

2021 ◽

pp. ijgc-2021-002432

Author(s):

Charlotte Maene ◽

Rawand Rokan Salihi ◽

Els Van Nieuwenhuysen ◽

Sileny N Han ◽

Nicole Concin ◽

...

Keyword(s):

Cervical Cancer ◽

Neoadjuvant Chemotherapy ◽

Response Rate ◽

Residual Disease ◽

Complete Response ◽

Pathological Response ◽

Weekly Paclitaxel ◽

Adjuvant Chemoradiotherapy ◽

Stromal Invasion ◽

Stage Ib

ObjectiveIn this study we investigated response rates of bevacizumab in addition to weekly paclitaxel and carboplatin in neoadjuvant setting in cervical cancer stage IB–IIB.MethodsIn this retrospective study we included patients with FIGO 2018 stage IB–IIB cervical cancer. Treatment consisted of 9 weeks' neoadjuvant paclitaxel and carboplatin (paclitaxel 60 mg/m2, carboplatin AUC 2.7; both weekly) and bevacizumab (15 mg/kg every 3 weeks). The radiologic response rate was analyzed using the Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 criteria. The definition of optimal pathological response was complete disappearance of tumor (complete response, pCR) or residual disease with less than 3 mm stromal invasion (pPR1). Suboptimal pathologic response (pPR2) was defined as persistent residual disease with more than 3 mm stromal invasion.ResultsA total of 30 patients were included. Six patients had FIGO 2018 stage IB1–IB2 (20%), one had stage IB3 (3%), five had stage IIA (17%), and 18 had stage IIB (60%). After completing the neoadjuvant chemotherapy, all patients showed a RECIST response (seven (23%) complete response; 23 (77%) partial response). Six patients (20%) were judged to be still inoperable. After radical hysterectomy, optimal pathological response was observed in 11 patients (38%) (pCR in nine patients (29%) and pPR1 in two patients (8%)). Six patients (20%) received postoperative adjuvant chemoradiotherapy. Hematological toxicity was similar to neoadjuvant weekly paclitaxel and carboplatin, as we reported earlier. Grade IV proteinuria or hypertension was not observed and no administration of bevacizumab was delayed or dose-reduced.ConclusionBevacizumab in addition to weekly paclitaxel and carboplatin showed a 100% radiological RECIST response and an optimal pathological response of 38%. Although bevacizumab has an established role in the treatment of recurrent cervical cancer in combination with paclitaxel and carboplatin, we did not observe a tendency toward superior effect on the pathological response rate of bevacizumab in the neoadjuvant chemotherapy setting.

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Preoperative adjuvant chemotherapy in the treatment of cervical cancer stage Ib, IIa, and IIb with bulky tumor

International Journal of Gynecology & Obstetrics ◽

10.1016/0020-7292(88)90177-4 ◽

1988 ◽

Vol 27 (3) ◽

pp. 486-486

Author(s):

Doo Sang Kim ◽

Moon Hyung ◽

Yeoun Yeoung Hwang ◽

Sam Hyun Cho

Keyword(s):

Cervical Cancer ◽

Adjuvant Chemotherapy ◽

Cancer Stage ◽

Stage Ib ◽

Bulky Tumor

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Prognostic effect of different cut-off values (20mm, 30mm and 40mm) for clinical tumor size in FIGO stage IB cervical cancer

Surgical Oncology ◽

10.1016/j.suronc.2009.04.004 ◽

2010 ◽

Vol 19 (2) ◽

pp. 106-113 ◽

Cited By ~ 7

Author(s):

Taner Turan ◽

Burcu Aykan Yildirim ◽

Gokhan Tulunay ◽

Nurettin Boran ◽

Mehmet Faruk Kose

Keyword(s):

Cervical Cancer ◽

Tumor Size ◽

Figo Stage ◽

Prognostic Effect ◽

Stage Ib

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Pathologic complete remission after preoperative intracavitary radiotherapy of cervical cancer stage Ib and IIa is a strong prognostic factor for long-term survival: analysis of the Radiumhemmet data 1989-1991

International Journal of Gynecological Cancer ◽

10.1046/j.1525-1438.2002.01089.x ◽

2002 ◽

Vol 12 (2) ◽

pp. 158-170 ◽

Cited By ~ 11

Author(s):

C. Beskow ◽

A.-K. Agren-Cronqvist ◽

F. Granath ◽

B. Frankendal ◽

R. Lewensohn

Keyword(s):

Cervical Cancer ◽

Survival Analysis ◽

Prognostic Factor ◽

Complete Remission ◽

Cancer Stage ◽

Term Survival ◽

Long Term Survival ◽

Stage Ib ◽

Pathologic Complete Remission

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A cut-off value of 2cm in tumor size is of prognostic value in surgically treated FIGO stage IB cervical cancer

Gynecologic Oncology ◽

10.1016/j.ygyno.2014.04.011 ◽

2014 ◽

Vol 134 (1) ◽

pp. 42-46 ◽

Cited By ~ 19

Author(s):

Lars-Christian Horn ◽

Karl Bilek ◽

Uta Fischer ◽

Jens Einenkel ◽

Bettina Hentschel

Keyword(s):

Cervical Cancer ◽

Tumor Size ◽

Prognostic Value ◽

Figo Stage ◽

Stage Ib

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Prognostic value of pathologic complete response to preoperative chemotherapy in early-stage non small cell lung cancer: Combined analysis of two IFCT randomized trials.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.7057 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. 7057-7057

Author(s):

Guillaume Mouillet ◽

Elisabeth Monnet ◽

Bernard Milleron ◽

Marc Puyraveau ◽

Elisabeth Quoix ◽

...

Keyword(s):

Lung Cancer ◽

Neoadjuvant Chemotherapy ◽

Preoperative Chemotherapy ◽

Early Stage ◽

Pathologic Complete Response ◽

Complete Response ◽

Small Cell ◽

Small Cell Lung ◽

Stage Ib ◽

Favorable Prognostic Factor

7057 Background: Our study aimed to evaluate whether pathologic complete response (pCR) in early-stage non-small cell lung cancer (NSCLC) following neoadjuvant chemotherapy resulted in improved outcome and to determine predictive factors for pCR. Methods: Eligible patients with stage IB or II NSCLC were included in two consecutive Intergroupe Francophone de Cancérologie Thoracique (IFCT) phase III trials evaluating platinum-based neoadjuvant chemotherapy, with pCR defined by the absence of viable cancer cells in the resected surgical specimen. Results: Among the 492 patients analyzed, 41 (8.3%) achieved pCR. In the pCR group, 5-year overall survival (OS) was 80.0% compared to 55.8% in the non-pCR group (p=0.0007). In multivariate analyses, pCR was a favorable prognostic factor of OS (RR=0.34; 95% CI=0.18-0.64) in addition to squamous cell carcinoma (SCC), weight loss ≤5%, and stage IB disease. Five-year disease-free survival (DFS) was 80.1% in the pCR group compared to 44.8% in the non-pCR group (p<0.0001). Two patients (4.9%) in the pCR group experienced disease recurrence compared to 193 patients (42.8%) in the non-pCR group. SCC subtype was the only independent predictor of pCR (OR=4.30; 95% CI=1.90-9.72). Conclusions: Our results showed that pCR after preoperative chemotherapy was a favorable prognostic factor in Stage IB-II NSCLC. Our study is the largest published series evaluating pCRs following preoperative chemotherapy. The only factor predictive of pCR was SCC. Identifying molecular predictive markers for pCR may help in distinguishing patients likely to benefit from neoadjuvant chemotherapy and in choosing the most adequate preoperative chemotherapy regimen.

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Neoadjuvant chemotherapy for locally advanced cervical cancer: Experience at the Instituto Oncologico Nacional SOLCA Guayaquil.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.e15571 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. e15571-e15571

Author(s):

Guillermo Paulson ◽

Katherine Garcia ◽

Mayra Santacruz ◽

Ruth Ginger Engracia ◽

Jose Francisco Mendoza

Keyword(s):

Cervical Cancer ◽

Neoadjuvant Chemotherapy ◽

Invasive Cervical Cancer ◽

Locally Advanced ◽

Progression Free Survival ◽

Complete Response ◽

Median Number ◽

Number Of Cycles ◽

Clinical Records ◽

Cancer Experience

e15571 Background: Cervical cancer is the most common malignancy of women in Ecuador. The main problem of concomitant chemo-radiotherapy (CRT) is the delay in starting radiation therapy, economic and logistical problems for high demand in radiotherapy. It has been neoadjuvant chemotherapy (NACT) followed by CRT the main treatment at our center in order to find an alternative to long waits before the start of radiotherapy. The aim of this study was to determine the response to NACT followed by CRT in terms progression-free survival (PFS) and overall survival (OS). Methods: diagnosed with invasive cervical cancer locally advanced stage II-III were analyzed retrospectively reviewed clinical records of pre-existing data from 2008 to 2010. Results: after meeting the criteria of exclusion, leaving 116 cases. The median age: 49 years (range: 28-82 years). The histology was 73% (85) squamous cell carcinoma, 26% (30) adenocarcinoma and 0.9% (1) not specified. Patients with stage IIB: 81.9% (95), IIIA: 10.3% (12), IIIB: 7.8% (9). Of the 116 patients 69% (80) received NACT. The main NACT was paclitaxel 175mg/m2 + Cisplatin 75mg/m2 every 3 weeks 63.8% (74), the remaining group received another protocol, the median number of cycles of NACT was 5 (1 - 8 cycles), the start of radiotherapy since the conclusion of NACT was 53 days on average (1 to 285 days) and the main regimen of CRT concomitant was cisplatin 40mg/m2 weekly 47.5% (38). In the 49 patients who underwent NACT followed by CRT, a radiological study showed, complete response (CR) 38.8% (19), 18.4% partial response (PR) (9), disease progression (DP) 12.2% (6), stable disease (SD) 8.2% (4) and the end of treatment evaluation gynecological was performed and CR was obtained in 59.2% (29). Persistent or progressive disease after treatment was 22.4% (11), recurrence was 12.2% (6), local recurrence 2.0% (1), distant metastasis 10.2% (5). OS of NACT followed by CRT was 93.9% (46) and PFS was 65.3% (32), OS after CR was 96% (25 / 1) and then 91.7% PR (24 / 2) with p: 0.439. Conclusions: NACT followed by CRT is a valid option because it improves disease-related symptoms, but OS did not improve significantly even after CR.

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