The rationale for the use of non-platinum chemotherapy doublets for metastatic and recurrent cervical carcinoma

Ongoing drug discovery and synergy in cytotoxic combinations have served as the dominant theme for clinical research in women with metastatic and recurrent cervical cancer. The results of the most recent phase III randomized clinical trials conducted by the Gynecologic Oncology Group in this population evaluated the tolerability and efficacy of cisplatin-based chemotherapy doublets. Possibly as a consequence of the increasing use of radiosensitizing cisplatin with concurrent pelvic radiotherapy for treatment of locally advanced disease prior to recurrence, the response rates obtained with platinum-based regimens have decreased with each successive trial. There is clearly a need for a re-appraisal of therapeutic options for women with recurrent and metastatic cervical cancer, many of whom may harbor platinum-resistant clones. In this article we will provide a rationale for the use of non-platinum-based chemotherapy doublets for this patient population.