Evaluation of the paclitaxel–ifosfamide–cisplatin (TIP) combination in relapsed and/or metastatic cervical cancer

BACKGROUND: Recurrent or metastatic cervical cancer represents an aggressive malignancy with a high rate of locoregional and distant failure. Therefore, we evaluated the three-drug combination of paclitaxel–ifosfamide–cisplatin (TIP). METHODS: Systemic chemotherapy-naive patients with advanced metastatic/relapsed cervical cancer and a World Health Organization (WHO) performance status (PS) of 0–2 were eligible. TIP chemotherapy doses were paclitaxel 175 mg m(−2) on day 1, ifosfamide 2.5 g m(−2) on days 1+2, and cisplatin 40 mg m(−2) on days 1+2, with prophylactic granulocyte-colony stimulating factor. RESULTS: A total of 42 patients with recurrent/metastatic cervical cancer are evaluable for response and toxicity: median age: 56 (25–74) years; PS: 1 (0–2); histologies – squamous: 35, adenosquamous: 5, and adenocarcinoma: 2. Responses were overall response rate (RR): 62% (95% confidence interval (CI): 47.3–76.7%), with complete response (CR): 26% (95% CI: 12.7–39.3%), and partial response (PR): 36% (95% CI: 21.5–49.9%). Responses according to the relapse site were overall RR: 32% (95% CI: 13.7–50.3%) within previously irradiated pelvis vs 75% (95% CI: 57.7–92.3%) in extra-pelvic sites. Median time to progression (TTP) was 7 (range, 2–34+) months and median overall survival (OS) was 16.5 (range, 3–36+) months. Toxicities included grade 3–4 neutropenia: 83% (21% febrile neutropenia), grade 3–4 thrombocytopenia: 9%, no grade 3 neuropathy (35% grade 2), grade 2 asthenia/fatigue 15%, and no treatment-related deaths. CONCLUSION: TIP is an active regimen with acceptable toxicity in advanced/relapsed cervical cancer.