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

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).

scholarly journals Caspase-3 can not be Used to Predict the Response to Neoadjuvant Chemotherapy Regiment PVB in Cervical Cancer Stage IB-IIA

2016 ◽  
pp. 156-160
Author(s):  
Ediwibowo Ambari ◽  
Hariyono Winarto ◽  
Bambang Sutrisna ◽  
Budiningsih Siregar
Keyword(s):  
Cervical Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Caspase 3 ◽  
Early Stage ◽  
Response To Therapy ◽  
Bivariate Analysis ◽  
Chemotherapy Response ◽  
Cancer Stage ◽  
Significant Difference ◽  
Early Stage Cervical Cancer

Objectives: To determine the factors that may be used as the prognostic parameter for the therapeutic efficacy of neoadjuvant chemotherapy, which can be used to revising the management of early stage cervical cancer patients with large lesions. Methods: This was a retrospective cohort study. The study was conducted in the Dr. Cipto Mangunkusumo Hospital, Faculty of Medicine, University of Indonesia. The subjects were 15 cervical cancer stage IB2 and IIA patients with lesions’ size of > 4 cm, who would be treated with neoadjuvant chemotherapy, consisted of cisplatin 50 mg/m2, vincristine 2 mg/m2 and bleomycin 15 mg regiment. The patients’ response would be evaluated after completing 3 series of chemotherapy. Data was retrieved from medical records and cervical biopsy paraffin blocks and examined histopathologically using IHC staining to see expression of caspase-3 with histoscore assessment score. Data was analyzed by univariate, bivariate analysis. Results: Response to PVB neoadjuvant chemotherapy was found in 5 out of 15 patients. None of the clinicopathology variables can be used to predict response to therapy. Expression of caspase-3 as a marker of apoptosis, can not predict the response of the therapy before administrating neoadjuvant chemotherapy either. There is a significant difference between the levels of caspase-3 in epidermoid carcinoma with adenocarcinoma, with p value of 0.02 (RR 6;95% CI 1.69-21.26). Conclusion: Clinicopathologic factors and the expression of caspase-3 before getting chemotherapy neoadjuvant can not predict the succeed of the therapy. [Indones J Obstet Gynecol 2013; 1-3: 156-60] Keywords: caspase -3, clinicopathologic, early-stage cervical cancer lession in large, neoadjuvant chemotherapy response to therapy

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

2019 ◽  
Vol 2 (3) ◽  
pp. 117-122
Author(s):  
Deri Edianto
Keyword(s):  
Cervical Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Tumor Size ◽  
Complete Response ◽  
Cancer Stage ◽  
Vegf Expression ◽  
Stage Ib ◽  
Cervical Biopsy ◽  
Biopsy Tissue ◽  
Chemotherapy Adjuvant

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

Squamous cell carcinoma antigen: prognostic significance and role in the monitoring of neoadjuvant chemotherapy response in cervical cancer.

1994 ◽  
Vol 12 (11) ◽  
pp. 2309-2316 ◽  
Author(s):  
G Scambia ◽  
P Benedetti Panici ◽  
E Foti ◽  
M Amoroso ◽  
G Salerno ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Squamous Cell Carcinoma ◽  
Neoadjuvant Chemotherapy ◽  
Squamous Cell ◽  
Locally Advanced ◽  
Chemotherapy Response ◽  
Advanced Cervical Cancer ◽  
Squamous Cell Carcinoma Antigen ◽  
Locally Advanced Cervical Cancer ◽  
Response To Neoadjuvant Chemotherapy

PURPOSE The aim of the study was to investigate the role of squamous cell carcinoma antigen (SCC) in the management of patients with locally advanced cervical cancer treated by neoadjuvant chemotherapy and radical surgery. PATIENTS AND METHODS SCC assay was performed with a radioimmunoassay kit in a series of 102 patients with locally advanced cervical cancer. The values of 2.5, 5, and 7 ng/mL were used to define SCC antigen positivity. The chi 2 and Fisher's exact test and the stepwise logistic regression were used to evaluate the distribution of marker values. Analysis of survival was performed using the Kaplan and Meier test and Cox multivariate regression analysis. RESULTS SCC levels were elevated in 65%, 45%, and 32% of patients with primary tumors for cutoff values of 2.5, 5, and 7 ng/mL, respectively. SCC pretreatment levels correlated with stage, tumor volume and lymph node status. In the multivariate analysis, SCC expression proved to be an independent predictor of response to neoadjuvant chemotherapy. SCC posttreatment levels were strongly related to chemotherapy response. Moreover, the overall correlation between the clinical course of the disease and the variation of SCC levels was 83%. In patients with squamous cell tumors, survival was significantly longer in SCC-negative cases compared with SCC-positive cases (P = .04). Moreover, in patients undergoing surgery after response to neoadjuvant chemotherapy, low SCC values were associated with better prognosis (P = .02). In the multivariate analysis, parametrial involvement and SCC status proved to retain an independent prognostic value. CONCLUSION Our data show that SCC assay may provide useful information to improve the prognostic characterization and disease monitoring of patients with locally advanced cervical cancer undergoing neoadjuvant chemotherapy.

scholarly journals Neoadjuvant Therapy in Operable Breast Cancer: Application to Triple Negative Breast Cancer

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Foluso O. Ademuyiwa ◽  
Matthew J. Ellis ◽  
Cynthia X. Ma
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Locally Advanced ◽  
Pathologic Complete Response ◽  
Chemotherapy Resistance ◽  
Treatment Strategies ◽  
Surrogate Endpoint ◽  
Complete Response

Systemic treatment for triple negative breast cancer (TNBC: negative for the expression of estrogen receptor and progesterone receptor and HER2 amplification) has been limited to chemotherapy options. Neoadjuvant chemotherapy induces tumor shrinkage and improves the surgical outcomes of patients with locally advanced disease and also identifies those at high risk of disease relapse despite today’s standard of care. By using pathologic complete response as a surrogate endpoint, novel treatment strategies can be efficiently assessed. Tissue analysis in the neoadjuvant setting is also an important research tool for the identification of chemotherapy resistance mechanisms and new therapeutic targets. In this paper, we review data on completed and ongoing neoadjuvant clinical trials in patients with TNBC and discuss treatment controversies that face clinicians and researchers when neoadjuvant chemotherapy is employed.

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

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.

scholarly journals Theurapeutic Response of Neoadjuvant Chemotherapy between Platinum and Ifosfamide Combination and Platinum, Vincristine and Bleomycin Combination in Cervical Carcinoma Stage IB2

2016 ◽  
Author(s):  
Kartiwa H Nuryanto ◽  
Sigit Purbadi
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Neoadjuvant Chemotherapy ◽  
Acute Toxicity ◽  
Cervical Carcinoma ◽  
Radical Hysterectomy ◽  
Complete Response ◽  
Pelvic Lymphadenectomy ◽  
Chemotherapy Response ◽  
Node Metastasis

Objective: To evaluate the theurapeutic response and acute toxicity of neoadjuvant chemotherapy between the combination of Platinum and Ifosfamide, and the combination of Platinum, Vincristine and Bleomycin in Cervical Carcinoma Stage IB2 and then continued with radical hysterectomy and pelvic lymphadenectomy. Method: Thirteen samples received neoadjuvant chemotherapy of Platinum and Ifosfamide and 17 samples received neoadjuvant chemotherapy of Platinum, Vincristine and Bleomycin, after receiving the neoadjuvant chemotherapy, clinically complete response samples underwent radical hysterectomy and pelvic lymphadenectomy (PI VS PVB = 3 VS 1). Histopathology examination was performed to evaluate the presence of malignant viable cells at the cervix, pelvic lymph node metastasis and parametrium metastasis. Acute toxicity evaluation was performed based on gastrointestinal, genitourinarius and hematology sign and symptom. Result: Theurapeutic response of PI is 1.12 higher than PVB (p>0.05). Subanalysis of group response of PI is 1.962 higher than PVB. PI and PVB have the same risk to have pelvic lymph node metastasis, but not parametrial metastasis. There were no differences in terms of the risk of gastrointestinal, genitourinarius and hematologic toxicity between PI and PVB. Conclusion: There was no statistical difference in clinical and pathological response, and also in acute toxicity between the two combination (p>0.05). [Indones J Obstet Gynecol 2016; 1: 47-51] Keywords: acute toxicity, cervical carcinoma stage IB2, neoadjuvant chemotherapy, response

scholarly journals Radiotherapy Response of Cervical Cancer Patients at a Tertiary Referral Hospital in Indonesia

2017 ◽  
pp. 230
Author(s):  
Hariyono Winarto ◽  
Nana Supriana
Keyword(s):  
Cervical Cancer ◽  
Radiation Therapy ◽  
Side Effects ◽  
Cancer Patients ◽  
Side Effect ◽  
Complete Response ◽  
Tumor Diameter ◽  
Cancer Stage ◽  
Post Radiation ◽  
Grade 3

Objective: To investigate the response of radiotherapy and related clinicopathologic characterictics on cervical cancer patients. Methods: This was a retrospective study. Subjects were patients diagnosed with cervical cancer stage IIA-IIIB who had undergone radiation therapy based on standard protocol in our hospital, during the period of January 2014 to December 2015. The clinical factors ofthose patients, such as age, Body Mass Index, blood pressure, hemoglobin level, blood leucocyte count, serum albumin, largest tumor diameter, the International Federation of Gynecology and Obstetrics (FIGO) staging, as well as pathologic characteristic, i.e histopathology and grading were recorded. During radiation protocol until 3months post radiation, we also noted any side effects of gastrointestinal tract, genitourinary tract, and hematologic. Evaluation of radiotherapy response was based on Response Evaluation Criteria in Solid Tumors (RECIST).  Results: A total of 123 subjects were enrolled in this study. 84 cases or 68.29% was complete response, 30 cases or 24.39% was partial response, 6 cases or 4.88% was stabile response, and 3 cases or 2.44% was progressive. Based on gastrointestinal side effect, there was no side effect or grade 0 on 99 cases (80.49%), grade 1 on 20 cases (16.26%), grade 2 on 4 cases (3.25%), grade 3 on 0 case (0%). Based on side effect of genitourinary, there was no side effect or grade 0 on 105 cases (85.37%), grade 1 on 17 cases (13.82%), grade 2 on 1 case (0.81%), grade 3 on 0 case (0%). Based on hematologic side effects, there was no side effecton 108 cases (87.80%), grade 1 on 15 cases (12.20%), grade 2 on 0 case (0%), grade 3 on 0 case (0%). Largest tumor diameter was statistically significant, with p=0.036 (RR 2.64 (1.07-6.56)). Conclusion: The majority of definitive-curative radiotherapy response on cervical cancer stage IIA-IIIB was complete (68.29%). Acute side effects involving the gastrointestinal, genitourinary, and hematologic system were commonly can be tolerable during and 3 months post radiation therapy. Clinicopathologic characteristics significantly associated with the complete response of radiotherapy was the largest tumor diameter. Keywords: largest tumor diameter, radiation response, radiationside effect

scholarly journals Vascular Endothelial Growth Factor-C (VEGF-C) Expression Can Not Predict Pelvic Lymph Node Metastases and Response to Neo-adjuvant Chemotherapy in Bulky Cervical Cancer

2016 ◽  
Author(s):  
Johnson Hutapea
Keyword(s):  
Cervical Cancer ◽  
Multivariate Analysis ◽  
Neoadjuvant Chemotherapy ◽  
Tumour Size ◽  
Response To Treatment ◽  
Chemotherapy Response ◽  
Response To Chemotherapy ◽  
The Difference ◽  
Neo Adjuvant Chemotherapy ◽  
Factor C

Objective: To assess whether VEGF-C expression can predict the response to neoadjuvant chemotherapy and pelvic lymphnode metastases in bulky cevical cancer. Methods: Seventeen cervical cancer stage IB2 and IIA2 cases during the period of July 2009 until June 2010 were collected consecutively and given neoadjuvant chemotherapy (NAC) PVB prior radical surgery. Response to treatment was evaluated based on the change of tumour size. VEGF-C expression was examined immunohistochemically at tumour biopsy before chemotherapy. The presence of lymphnode metastases histopathologically were obtained from pelvic lymphnode dissection. The difference and correlation of response and metastases on VEGF-C expression were analized statistically. The validity of the cut off percentage of immunopositive cells to VEGF-C to identify non responding and metastatic cases was calculated with the ROC. Multivariate analysis were done to determine the predictor of no response to chemotherapy. Results: Clinical response, using the RECIST version 1.1 criteria, was found in 41.18% cases and lymphnode metastases were found in 27.27% cases. VEGF-C was expressed in all cases. Statistically, there were no significant differences and correlation in response to treatment and pelvic lymphnode metastases on VEGF-C expression. At the cut off ≥ 76% immunopositivity to VEGF-C, the sensitivity to identify no response and the specificity to identify response to NAC are 70.00% and 71.43% respectively (LR+ 2.45 and LR- 0.42); whereas at the cut off ≥ 75% immunopositivity to VEGF-C, the sensitivity to identify lymphnode metastases and the specificity to identify no lymphnode metastases are 100.00% and 75.00% (LR+ 4.0 and LR- 0). With multivariate analysis using logistic regression, the cut off ≥ 76% immunopositive cells to VEGF-C were found to have positive coefficient, largest OR and statistic score, 1.93, 6.88 (96% CI OR 0.45; 104.34) and 41 respectively, to predict non responders in a prediction score model. Conclusion: VEGF-C expression on biopsy specimen bulky cervical cancers can not differentiate cases that respond to NAC and metastases to the pelvic lymphnode from that do not. The cut off ≥ 76% immunopositive cells to VEGF-C in a prediction model can be used as an alternative predictor to identify non responders. [Indones J Obstet Gynecol 2012; 36-3: 144-9] Keywords: bulky cervical cancer, neoadjuvant chemotherapy, response and metastases prediction, VEGF-C immunohistochemistry expression

Use of carboplatinum as neoadjuvant setting for patients affected by locally advanced cervical cancer.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e15553-e15553
Author(s):  
Carlo De Cicco Nardone ◽  
Francesco Plotti ◽  
Michela Angelucci ◽  
Roberto Montera ◽  
Patrizio Damiani ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Response Rate ◽  
Locally Advanced ◽  
Complete Response ◽  
World Health ◽  
Advanced Cervical Cancer ◽  
Locally Advanced Cervical Cancer ◽  
Grade 3 ◽  
Health Organization

e15553 Background: The aim of this study is to evaluate the efficacy and safety of the combination of carboplatin and paclitaxel as neoadjuvant chemotherapy (NACT) in patients affected by locally advanced cervical cancer. Methods: Between June 2007 to May 2009, all patients with diagnosis of IB2-IIB cervical cancer were considered eligible for this protocol. All enrolled patients received 3 cycles of carboplatin (AUC6) and paclitaxel at 175 mg/mq in neadjuvant setting. The chemotherapy induced toxicity and response to the treatment were evaluated according to World Health Organization criteria. Results: We have enrolled 23 patients with diagnosis of locally advanced cervical cancer. A total of 22 patients completed planned 3 cycles of neoadjuvant chemotherapy. After 3 cycles of chemotherapy 9 out of 23 patients (42%) showed a complete response, 7 patients (35%) partial response, 5 patients (16%) stable disease and 2 patients (11%) showed disease progression. The most common toxicity was haematologic (43%), extra haematologic toxicities were nausea/vomiting, neuropathy and alopecia, that occurred in 45%, 13% and 25% respectively. No renal and grade 3 and 4 haematologic toxicities were registered. Conclusions: Our results suggest that the use of carboplatin, in neadjuvant setting, is a well tolerated drug, produces manageable toxicity with a response rate similar to standard cisplatin. Then, it rappresents a valid alternative in patients affected by locally advanced cervical cancer.

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