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 Cervical cancer develops when malignant cells form in the tissues of the cervix. The disease was once one of the most common causes of cancer death for American women. Due to increased screening via a Pap test, however, the number of cancer deaths in the United States dropped by 74% between 1955 and 1992. The death rate continues to decline by nearly 4% each year. Still, the American Cancer Society estimates in 2006 there will be about 9,710 cases of invasive cervical cancer in the United States with 3,700 deaths. [35] It remains the third most common gynecologic malignancy. There are 2 main types of cervical cancer:
Cervical cancer is initially treated with surgery and/or chemoradiotherapy and/or combination chemotherapy. While most patients respond to frontline therapy, disease recurrence is common. In patients with recurrent or persistent disease, response rates and overall survival rates remain low. New clinical trials are investigating agents, used either alone or in combination, that will prove more effective in increasing overall survival. [33] Learn more about cervical cancer:
Important Safety InformationContraindicationsHycamtin is contraindicated in patients who have a history of hypersensitivity reactions to topotecan or to any of its ingredients. Hycamtin should not be used in patients who are pregnant or breast-feeding, or those with severe bone marrow depression.WarningsHycamtin should be used only in patients with adequate bone marrow reserves, including baseline neutrophil counts of at least 1,500 cells/mm3 and platelet counts of at least 100,000/mm3. Frequent monitoring of blood counts should be instituted during treatment with Hycamtin.Patients should not be treated with subsequent courses of Hycamtin until neutrophils recover to >1,000 cells/mm3, platelets recover to >100,000 cells/mm3, and hemoglobin levels recover to 9.0 g/dL (with transfusion if necessary). Hycamtin may cause fetal harm when administered to a pregnant woman. Women of childbearing potential should be advised to avoid becoming pregnant during therapy with Hycamtin. Drug InteractionsConcomitant administration of G-CSF can prolong the duration of neutropenia, so if G-CSF is to be used, it should not be initiated until day 6 of the course of therapy, 24 hours after completion of treatment with Hycamtin.Myelosuppression was more severe when Hycamtin was given in combination with cisplatin in phase I studies. In a reported study on concomitant administration of cisplatin 50 mg/m² and Hycamtin at a dose of 1.25 mg/m²/day x 5 days, 1 of 3 patients had severe neutropenia for 12 days, and a second patient died with neutropenic sepsis. There are no adequate data to define a safe and effective regimen for Hycamtin and cisplatin in combination. Adverse EventsFrequently reported nonhematologic adverse events associated with use of Hycamtin included nausea (64%), vomiting (45%), diarrhea (32%), alopecia (49%), fatigue (29%), and dyspnea (22%). Most nonhematologic toxicities were grade 1 or 2. |
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