ABSTRACT
The important therapeutic activity of 13-cRA and IFN-alpha-2a in carcinoma of squamous cells, cervical, without previous treatment, is confirmed. An unexpected result was the early toxicity of the biologic agents on the colon mucosa when they are combined with radiotherapy.
Subject(s)
Carcinoma, Squamous Cell/drug therapy , Carcinoma, Squamous Cell/radiotherapy , Interferon-alpha/therapeutic use , Isotretinoin/therapeutic use , Uterine Cervical Neoplasms/drug therapy , Uterine Cervical Neoplasms/radiotherapy , Adult , Aged , Brachytherapy , Cesium Radioisotopes/administration & dosage , Cobalt Radioisotopes/therapeutic use , Colon/drug effects , Colon/radiation effects , Combined Modality Therapy , Evaluation Studies as Topic , Female , Humans , Interferon alpha-2 , Interferon-alpha/toxicity , Intestinal Mucosa/drug effects , Intestinal Mucosa/radiation effects , Isotretinoin/toxicity , Middle Aged , Radiotherapy/adverse effects , Radiotherapy Dosage , Recombinant ProteinsABSTRACT
BACKGROUND: The use of chemotherapy for cervical squamous cell carcinoma has shown some positive results. Total percentage of complete plus partial responses are near 30% with the use of single cytotoxic agents. Higher percentages are achievable with combined chemotherapy including platinum but the lack of evidence that current chemotherapy can increase survival, coupled with a devastating worldwide mortality, indicates the urgent need for more effective therapies. OBJECTIVE: To further assess the role of 13-cis-Retinoic acid (13-cRA) plus interferon alfa (IFN-alfa) in a prospective phase II trial in advanced cervical cancer. METHODS: Thirty two women with untreated cervical carcinoma, with median age of 42 years (24 to 60 years) and median Zubrod performance of 1 (range 0-2) were treated for at least two months with oral 13-cRA (1 mg/kg/day) and IFN-alfa 2a (subcutaneously, 6 million units daily). RESULTS: Sixteen patients (50%) had major responses, including four complete clinical responses. Major response rate in regard to disease stage were 100% in the four patients with stage IVA, 36% (4/11) in stage IIIB, 50% (4/8) in stage IIB, 50% (1/2) in stage IIA, and 43% (3/7) in stage IB. Remission of the cancer in 15 patients was reached after only two months of treatment and in one patient within one month. Dose escalations after two months of therapy in nonresponding patients had no effect. Toxicity to treatment was manageable. Twenty one patients had poorly differentiated tumors. CONCLUSIONS: These preliminary results indicate that systemic 13-cRA plus IFN-alfa 2a is a highly active, well tolerated therapy for locally advanced squamous cell carcinoma of the cervix, with potential to be used in the primary, adjuvant and salvage therapy of cervical cancer. This therapy warrants further study.
Subject(s)
Carcinoma, Squamous Cell/therapy , Immunologic Factors/therapeutic use , Interferon-alpha/therapeutic use , Isotretinoin/therapeutic use , Uterine Cervical Neoplasms/therapy , Adult , Aged , Anorexia/chemically induced , Carcinoma, Squamous Cell/pathology , Cheilitis/chemically induced , Conjunctivitis/chemically induced , Fatigue/chemically induced , Female , Humans , Immunologic Factors/adverse effects , Interferon alpha-2 , Interferon-alpha/adverse effects , Isotretinoin/adverse effects , Liver Function Tests , Middle Aged , Neoplasm Staging , Prospective Studies , Recombinant Proteins , Remission Induction , Treatment Outcome , Uterine Cervical Neoplasms/pathologyABSTRACT
The primary objective of this report is to provide medical oncologists and infectious disease specialists with pertinent information on the diagnosis and management of various infectious and especially tropical diseases as they affect cancer and other immunocompromised patients in the largest general hospital in Mexico. Limited, but hopefully stimulating, data are presented here that should permit better understanding of the magnitude and geographic peculiarities that these illnesses have in a segment of the population that includes primarily the poorest and the sickest.