Pilot trial of cisplatin, radiation, and WR2721 in carcinoma of the uterine cervix: A New York gynecologic oncology group study

Purpose: A phase I trial of WR2721 was initiated to determine the maximal safe dose for incorporation into a consecutive 5-day schedule of cisplatin administered concurrently with radiation therapy in patients with cervical cancer. Patients and Methods: WR2721 was administered at 340 to 910 mg/m²/d immediately before cisplatin. Cisplatin was administered at 20 mg/m²/d for 5 days every 3 weeks in combination with external-beam radiation therapy and at 100 mg/m² after each brachytherapy treatment. Pelvic radiation consisted of external-beam therapy to a dose of 39.6 Gy, followed by brachytherapy with cesium 137 tandem and ovoid insertions to deliver 80 Gy to point A and 55 Gy to point B. Results: Twenty patients were enrolled; 19 were as-sessable. The dose-limiting toxicity of WR2721 was hypotension. No patients developed serious sequelae, but hypotension required a reduction in the dose of WR2721 at the highest dose level tested. The major grade 3 or 4 toxicities included transient azotemia (five of 19), leukopenia (nine of 19), vomiting (four of 19), and neurotoxicity (two of 19). One patient experienced an anaphylactic reaction to cisplatin. Conclusion: The recommended dose of WR2721 administered in conjunction with cisplatin on a daily × 5 schedule plus radiation therapy is 825 mg/m²/d for 5 days.