Current status of chemotherapy for cancer of the cervix

There clearly is a need for effective chemotherapy for early-stage, high-risk patients with carcinoma of the uterine cervix, and for those with advanced disease. Results to date have been disappointing. Cisplatin is active but overrated. Ifosfamide and dibromodulcitol are of interest, but unproven in this disease. Vinblastine and etoposide deserve further evaluation. New drug combinations require careful study, with the initial focus on women with little or no prior chemotherapy, and with adequate sample size. Patient selection needs to be precise with respect to prognostic factors for response and survival, so that results will be more reproducible. Trials of neoadjuvant chemotherapy in locally advanced disease should be randomized; non-randomized trials should be discouraged. Systemic therapy for cervical cancer remains experimental.