Chemotherapy for advanced cervical cancer with methotrexate, bleomycin, and cis-dichlorodiammineplatinum(II)

Nine patients with advanced cancer of the uterine cervix, having failed radiotherapy, were treated with a combination regimen of parenteral methotrexate, bleomycin, and cis-dichlorodiammineplatinum(II). Eight of the patients had objective partial remissions lasting a median of 4 months. All patients improved subjectively. Five of the patients, however, had sudden unpredictable onset of severe myelosuppression accompanied by stomatitis. Such frequent severe toxicity was not observed in patients with other malignancies treated with this combination. It is likely that impaired excretion of methotrexate resulting from ureteral dysfunction led to increased toxicity. In future protocols for advanced cervical cancer, methotrexate will be replaced by other effective agents. The very high response rate (89%) suggests that similar but less toxic combinations may contribute substantially to the future effective treatment of advanced cervical cancer.