Management of advanced or recurrent cervical cancer: chemotherapy and beyond

Metastatic or recurrent cervical cancer has a survival duration of approximately 12 months. Thus, we review the outcomes of chemotherapy and/or novel agents for women who present in this situation. Included were studies in women with advanced or recurrent cervical cancer where at least response rate, survival or toxicity were reported. Platinum alone chemotherapy at 50 mg/m(2) is superior to other single-agent platinum or nonplatinum regimens in terms of efficacy and toxicity profile. Platinum with either paclitaxel, gemcitibine, topotecan or vinorelbine has equivalent efficacy but differ with respect to toxicity profile and convenience of treatment regimen. Bevacizumab in addition to combination chemotherapy provides a duration of survival that is 3.7 months longer than that provided by combination chemotherapy alone. EGF receptor (EGFR) tyrosine kinase inhibitor agents did not provide promising efficacy. Bevacizumab in addition to combination chemotherapy provides superior efficacy with acceptable toxicity. Evaluation of other novel targeted antiangiogenic agents, either alone or in combination with chemotherapy is ongoing.