Chemotherapy for recurrent and metastatic cervical cancer with standard-dose methotrexate-leucovorin, bleomycin and cis-platinum

Recurrent and advanced cervical cancers that are no longer amenable to therapy with radiation or surgery are common and difficult to treat. Although an excellent response rate (89%) was obtained in a previous trial in such patients by utilizing a combination of cis-platinum, methotrexate and bleomycin, the toxicity was excessive, apparently due to impaired renal excretion of methotrexate. Therefore, leucovorin was added to the regimen in an attempt to diminish the toxicity. Although it did result in significantly diminished toxicity, it also diminished the efficacy of the regimen's antitumor effect.