Doctors at Washington University School of Medicine in St. Louis have shown that testing cervical tumors before treatment for vulnerability to chemotherapy predicts whether patients will do well or poorly with standard treatment. The study, which appears online in the journal Gynecologic Oncology, supports the possibility of personalized medicine for cervical cancer.
Since 1999, nearly all cervical cancer cases have been treated with daily radiation therapy targeted to the tumor plus a weekly intravenous infusion of the chemotherapy drug cisplatin. However, clinicians have had no way of knowing how individual patients will fare with the combined radiation and chemotherapy. The Wash U. researchers have shown that the tumor’s response to chemotherapy, independent of radiation, may be a major factor in whether a patient will do well with the standard treatment.
“This is evidence that cisplatin is not just helping the radiation work better,” says co-author Julie K. Schwarz, MD, PhD. “It is having some direct toxic effect on cancer cells that may be hiding elsewhere in the body.”
Researchers tested tumors from 33 cervical cancer patients before their treatment began. They divided tumors into three categories—responsive, intermediate response, and nonresponsive—based on how well cisplatin killed the tumor cells growing in a dish.
For tumors categorized as responsive—those with cancer cells that cisplatin killed most easily—100% of the patients were alive and disease-free after two years. For those that showed an intermediate response, 83% were alive and disease-free after two years. For tumors deemed nonresponsive, 58% of patients had two-year disease-free survival. Read the study abstract.
