Cisplatin in advanced cancer of the cervix: an update

Cisplatin is the single most active cytotoxic agent in the treatment of patients with recurrent or metastatic squamous cell cancer of the cervix; no other standard drug has been associated consistently with objective response rates of 25% or higher. However, cervical cancer is a relatively drug-resistant disease and prolonged cisplatin treatment appears to induce multiple mechanisms of tumor resistance. The majority of objective responses to cisplatin are partial and relatively short-lived and, therefore, have little impact on survival duration. Complete responses to cisplatin are seen predominantly in patients with extrapelvic metastases rather than pelvic recurrences. This article examines the role of cisplatin in the management of advanced cervical cancer with emphasis on its efficacy in the following circumstances: as a single agent; in combination with other cytotoxic drugs; in previously treated patients; and when administered before surgery or before or concurrent with definitive radiation therapy.