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Chemotherapy for Advanced and Recurrent Cervical Cancer

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Recent Topics on Prevention, Diagnosis, and Clinical Management of Cervical Cancer

Part of the book series: Comprehensive Gynecology and Obstetrics ((CGO))

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Abstract

For patients with advanced and recurrent cervical cancer, chemotherapy remains the standard treatment, although it is neither curative nor associated with long-term disease control. In this chapter, we summarized the history of treatment of advanced and recurrent cervical cancer and the current recommendation for chemotherapy and anti-angiogenic therapy. Since cisplatin every 21 days was considered as the historical standard treatment for recurrent cervical cancer, subsequent trials have evaluated and demonstrated activity for other agents including paclitaxel, gemcitabine, topotecan, and vinorelbine, among others. Accordingly, promising agents were incorporated into phase III trials. To examine the best agent to combine with cisplatin, several landmark phase III clinical trials were conducted by Gynecologic Oncology Group (GOG) and Japan Clinical Oncology Group (JCOG). Through GOG204 and JCOG0505, paclitaxel/cisplatin (TP) and paclitaxel/carboplatin (TC) are now considered to be the recommended therapies for recurrent cervical cancer patients. However, the prognosis of patients who are already resistant to chemotherapy is very poor. Therefore new therapeutic strategies are urgently required. Molecular-targeted therapy will be the most hopeful candidate of these strategies. From the results of GOG240, bevacizumab combined with TP reached its primary endpoint of improving overall survival (OS). Although the prognosis for recurrent cervical cancer patients is still poor, the results of GOG240 shed light on the usefulness of molecular target agents to chemotherapy in cancer patients. Recurrent cervical cancer is generally considered incurable and current chemotherapy regiments offer only modest gains in OS, particularly for patients with multiple poor prognostic factors. Therefore, it is crucial to consider not only the survival benefit but also the minimization of treatment toxicity and maximization of quality of life (QOL).

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References

  1. Safaeian M, Solomon D, Castle PE. Cervical cancer prevention-cervical screening: science in evolution. Obstet Gynecol Clin N Am. 2007;34:739–60.

    Article  Google Scholar 

  2. Greer BE, Koh WJ, Abu-Rustum NR, Apte SM, Campos SM, Chan J, Cho KR, Copeland L, Crispens MA, Dupont N, Eifel PJ, Gaffney DK, Huh WK, Kapp DS, Lurain JR 3rd, Martin L, Morgan MA, Morgan RJ Jr, Mutch D, Remmenga SW, Reynolds RK, Small W Jr, Teng N, Valea FA, National Comprehensive Cancer Networks. Cervical cancer. J Natl Compr Cancer Netw. 2010;8:1388–416.

    Article  Google Scholar 

  3. DiSaia PJ, Creasman WT. Clinical gynecologic oncology. 6th ed. St. Louis: Mosby; 2002.

    Google Scholar 

  4. Thigpen T, Shingleton H, Homesley H, Lagasse L, Blessing J. Cis- platinum in treatment of advanced or recurrent squamous cell carcinoma of the cervix: a phase II study of the gynecologic oncology group. Cancer. 1981;48:899–903.

    Article  CAS  PubMed  Google Scholar 

  5. Hsiang YH, Liu LF. Identification of mammalian DNA topoisomerase I as intracellular targets of the anticancer drug camptothecin. Cancer Res. 1988;48:1722–6.

    CAS  PubMed  Google Scholar 

  6. Chou TC, Motzer RJ, Tong Y, Bosl GJ. Computerized quantitation of synergism and antagonism of taxol, topotecan, and cisplatin against human teratocarcinoma cell growth: a rational approach to clinical protocol design. J Natl Cancer Inst. 1994;86:1517–24.

    Article  CAS  PubMed  Google Scholar 

  7. Bookman MA, Blessing JA, Hanjani P, Herzog TJ, Andersen WA. Topotecan in squamous cell carcinoma of the cervix: a phase II study of the gynecologic oncology group. Gynecol Oncol. 2000;77:446–9.

    Article  CAS  PubMed  Google Scholar 

  8. Verschraegen CF, Levy T, Kudelka AP, Llerena E, Ende K, Freedman RS, Edwards CL, Hord M, Steger M, Kaplan AL, Kieback D, Fishman A, Kavanagh JJ. Phase II study of irinotecan in prior chemotherapy-treated squamous cell carcinoma of the cervix. J Clin Oncol. 1997;15:625–31.

    Article  CAS  PubMed  Google Scholar 

  9. Curtin JP, Blessing JA, Webster KD, Rose PG, Mayer AR, Fowler WC Jr, Malfetano JH, Alvarez RD. Paclitaxel, an active agent in nonsquamous carcinomas of the uterine cervix: a gynecologic oncology group study. J Clin Oncol. 2001;19:1275–8.

    Article  CAS  PubMed  Google Scholar 

  10. Gradishar WJ. Albumin-bound paclitaxel: a next-generation taxane. Expert Opin Pharmacother. 2006;7:1041–53.

    Article  CAS  PubMed  Google Scholar 

  11. Micha JP, Goldstein BH, Birk CL, Rettenmaier MA, Brown JV 3rd. Abraxane in the treatment of ovarian cancer: the absence of hypersensitivity reactions. Gynecol Oncol. 2006;100:437–8.

    Article  CAS  PubMed  Google Scholar 

  12. Alberts DS, Blessing JA, Landrum LM, Warshal DP, Martin LP, Rose SL, Bonebrake AJ, Ramondetta LM. Phase II trial of nab-paclitaxel in the treatment of recurrent or persistent advanced cervix cancer: a gynecologic oncology group study. Gynecol Oncol. 2012;127:451–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Sutton GP, Blessing JA, DiSaia PJ, McGuire WP, Adcock L. Phase II study of ifosfamide and mesna in nonsquamous carcinoma of the cervix: a gynecologic oncology group study. Gynecol Oncol. 1993;49:48–50.

    Article  CAS  PubMed  Google Scholar 

  14. McGuire WP, Blessing JA, Moore D, Lentz SS, Photopulos G. Paclitaxel has moderate activity in squamous cervix cancer. A gynecologic oncology group study. J Clin Oncol. 1996;14:792–5.

    Article  CAS  PubMed  Google Scholar 

  15. Rose PG, Blessing JA, Arseneau J. Phase II evaluation of altretamine for advanced and recurrent squamous cell carcinoma of the cervix: a gynecologic oncology group study. Gynecol Oncol. 1996;62:100–2.

    Article  CAS  PubMed  Google Scholar 

  16. Rose PG, Blessing JA, Van Le L, Waggoner S. Prolonged oral etoposide in recurrent or advanced squamous cell carcinoma of the cervix: a gynecologic oncology group study. Gynecol Oncol. 1998;70:263–6.

    Article  CAS  PubMed  Google Scholar 

  17. Rose PG, Blessing JA, Buller RE, Mannel RS, Webster KD. Prolonged oral etoposide in recurrent or advanced non-squamous cell carcinoma of the cervix: a gynecologic oncology group study. Gynecol Oncol. 2003;89:267–70.

    Article  CAS  PubMed  Google Scholar 

  18. Schilder RJ, Blessing JA, Morgan M, Mangan CE, Rader JS. Evaluation of gemcitabine in patients with squamous cell carcinoma of the cervix: a phase II study of the gynecologic oncology group. Gynecol Oncol. 2000;76:204–7.

    Article  CAS  PubMed  Google Scholar 

  19. Schilder RJ, Blessing J, Cohn DE. Evaluation of gemcitabine in previously treated patients with non-squamous cell carcinoma of the cervix: a phase II study of the gynecologic oncology group. Gynecol Oncol. 2005;96:103–7.

    Article  CAS  PubMed  Google Scholar 

  20. Muderspach LI, Blessing JA, Levenback C, Moore JL Jr. V a phase II study of topotecan in patients with squamous cell carcinoma of the cervix: a gynecologic oncology group study. Gynecol Oncol. 2001;8:213–5.

    Article  Google Scholar 

  21. Look KY, Blessing JA, Levenback C, Kohler M, Chafe W, Roman LD. A phase II trial of CPT-11 in recurrent squamous carcinoma of the cervix: a gynecologic oncology group study. Gynecol Oncol. 1998;70:334–8.

    Article  CAS  PubMed  Google Scholar 

  22. Look KY, Blessing JA, Valea FA, McGehee R, Manetta A, Webster KD, Andersen WA. Phase II trial of 5-fluorouracil and high-dose leucovorin in recurrent adenocarcinoma of the cervix: a gynecologic oncology group study. Gynecol Oncol. 1997;67:255–8.

    Article  CAS  PubMed  Google Scholar 

  23. Look KY, Blessing JA, Gallup DG, Lentz SS. A phase II trial of 5-fluorouracil and high-dose leucovorin in patients with recurrent squamous cell carcinoma of the cervix: a gynecologic oncology group study. Am J Clin Oncol. 1996;19:439–41.

    Article  CAS  PubMed  Google Scholar 

  24. Garcia AA, Blessing JA, Vaccarello L, Roman LD, Gynecologic Oncology Group Study. Phase II clinical trial of docetaxel in refractory squamous cell carcinoma of the cervix: a gynecologic oncology group study. Am J Clin Oncol. 2007;30:428–31.

    Article  CAS  PubMed  Google Scholar 

  25. Garcia AA, Blessing JA, Darcy KM, Lenz HJ, Zhang W, Hannigan E, Moore DH. Phase II clinical trial of capecitabine in the treatment of advanced, persistent or recurrent squamous cell carcinoma of the cervix with translational research: a gynecologic oncology group study. Gynecol Oncol. 2007;104:572–9.

    Article  CAS  PubMed  Google Scholar 

  26. Rose PG, Blessing JA, Lele S, Abulafia O. Evaluation of pegylated liposomal doxorubicin (Doxil) as second-line chemotherapy of squamous cell carcinoma of the cervix: a phase II study of the gynecologic oncology group. Gynecol Oncol. 2006;102:210–3.

    Article  CAS  PubMed  Google Scholar 

  27. Muggia FM, Blessing JA, Method M, Miller DS, Johnson GA, Lee RB, Menzin A. Gynecologic oncology group study. Evaluation of vinorelbine in persistent or recurrent squamous cell carcinoma of the cervix: a gynecologic oncology group study. Gynecol Oncol. 2004;92:639–43.

    Article  CAS  PubMed  Google Scholar 

  28. Muggia FM, Blessing JA, Waggoner S, Berek JS, Monk BJ, Sorosky J, Pearl ML. Evaluation of vinorelbine in persistent or recurrent nonsquamous carcinoma of the cervix: a gynecologic oncology group study. Gynecol Oncol. 2005;96:108–11.

    Article  CAS  PubMed  Google Scholar 

  29. Lhommé C, Vermorken JB, Mickiewicz E, Chevalier B, Alvarez A, Mendiola C, Pawinski A, Lentz MA, Pecorelli S. Phase II trial of vinorelbine in patients with advanced and/or recurrent cervical carcinoma: an EORTC Gynaecological cancer cooperative group study. Eur J Cancer. 2000;36:194–9.

    Article  PubMed  Google Scholar 

  30. Weiss GR, Green S, Hannigan EV, Boutselis JG, Surwit EA, Wallace DL, Alberts DS. A phase II trial of carboplatin for recurrent or metastatic squamous carcinoma of the uterine cervix: a southwest oncology group study. Gynecol Oncol. 1990;39:332–6.

    Article  CAS  PubMed  Google Scholar 

  31. Fiorica J, Holloway R, Ndubisi B, Orr J, Grendys E, Boothby R, DeCesare S, LaPolla J, Hoffman M, Patel J. Phase II trial of topotecan and cisplatin in persistent or recurrent squamous and nonsquamous carcinomas of the cervix. Gynecol Oncol. 2002;85:89–94.

    Article  CAS  PubMed  Google Scholar 

  32. Rose PG, Blessing JA, Gershenson DM, McGehee R. Paclitaxel and cisplatin as first-line therapy in recurrent or advanced squamous cell carcinoma of the cervix: a gynecologic oncology group study. J Clin Oncol. 1999;17:2676–80.

    Article  CAS  PubMed  Google Scholar 

  33. Tinker AV, Bhagat K, Swenerton KD, Hoskins PJ. Carboplatin and paclitaxel for advanced and recurrent cervical carcinoma: the British Columbia Cancer Agency experience. Gynecol Oncol. 2005;98:54–8.

    Article  CAS  PubMed  Google Scholar 

  34. Stehman FB, Blessing JA, McGehee R, Barrett RJ. A phase II evaluation of mitolactol in patients with advanced squamous cell carcinoma of the cervix: a gynecologic oncology group study. J Clin Oncol. 1989;7:1892–5.

    Article  CAS  PubMed  Google Scholar 

  35. Bonomi P, Blessing JA, Stehman FB, DiSaia PJ, Walton L, Major FJ. Randomized trial of three cisplatin dose schedules in squamous-cell carcinoma of the cervix: a gynecologic oncology group study. J Clin Oncol. 1985;3:1079–85.

    Article  CAS  PubMed  Google Scholar 

  36. Omura GA, Blessing JA, Vaccarello L, Berman ML, Clarke-Pearson DL, Mutch DG, Anderson B. Randomized trial of cisplatin versus cisplatin plus mitolactol versus cisplatin plus ifosfamide in advanced squamous carcinoma of the cervix: a gynecologic oncology group study. J Clin Oncol. 1997;15:165–71.

    Article  CAS  PubMed  Google Scholar 

  37. Bloss JD, Blessing JA, Behrens BC, Mannel RS, Rader JS, Sood AK, Markman M, Benda J. Randomized trial of cisplatin and ifosfamide with or without bleomycin in squamous carcinoma of the cervix: a gynecologic oncology group study. J Clin Oncol. 2002;20:1832–7.

    Article  CAS  PubMed  Google Scholar 

  38. Moore DH, Blessing JA, McQuellon RP, Thaler HT, Cella D, Benda J, Miller DS, Olt G, King S, Boggess JF, Rocereto TF. Phase III study of cisplatin with or without paclitaxel in stage IVB, recurrent, or persistent squamous cell carcinoma of the cervix: a gynecologic oncology group study. J Clin Oncol. 2004;22:3113–9.

    Article  CAS  PubMed  Google Scholar 

  39. Long HJ III, Bundy BN, Grendys EC Jr, Benda JA, McMeekin DS, Sorosky J, Miller DS, Eaton LA, Fiorica JV. Gynecologic oncology group study. Randomized phase III trial of cisplatin with or without topotecan in carcinoma of the uterine cervix: a gynecologic oncology group study. J Clin Oncol. 2005;23:4626–33.

    Article  CAS  PubMed  Google Scholar 

  40. Monk BJ, Sill MW, McMeekin DS, Cohn DE, Ramondetta LM, Boardman CH, Benda J, Cella D. Phase III trial of four cisplatin-containing doublet combinations in stage IVB, recurrent, or persistent cervical carcinoma: a gynecologic oncology group study. J Clin Oncol. 2009;27:4649–55.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  41. Kitagawa R, Katsumata N, Shibata T, Kamura T, Kasamatsu T, Nakanishi T, Nishimura S, Ushijima K, Takano M, Satoh T, Yoshikawa H. Paclitaxel plus carboplatin versus paclitaxel plus cisplatin in metastatic or recurrent cervical cancer: the open-label randomized phase III trial (JCOG0505). J Clin Oncol. 2015;33:2129–35.

    Article  CAS  PubMed  Google Scholar 

  42. Rahimi N. The ubiquitin-proteasome system meets angiogenesis. Mol Cancer Ther. 2012;11:538–48.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  43. Wahl O, Oswald M, Tretzel L, Herres E, Arend J, Efferth T. Inhibition of tumor angiogenesis by antibodies, synthetic small molecules and natural products. Curr Med Chem. 2011;18:3136–55.

    Article  CAS  PubMed  Google Scholar 

  44. Folkman J. Tumor angiogenesis: therapeutic implications. N Engl J Med. 1971;285:1182–6.

    Article  CAS  PubMed  Google Scholar 

  45. Gasparini G. Prognostic value of vascular endothelial growth factor in breast cancer. Oncologist. 2000;5(Suppl 1):37–44.

    Article  CAS  PubMed  Google Scholar 

  46. Ferrara N. Vascular endothelial growth factor: basic science and clinical progress. Endocr Rev. 2004;25:581–611.

    Article  CAS  PubMed  Google Scholar 

  47. Cheng WF, Chen CA, Lee CN, Wei LH, Hsieh FJ, Hsieh CY. Vascular endothelial growth factor and prognosis of cervical carcinoma. Obstet Gynecol. 2000;96:721–6.

    CAS  PubMed  Google Scholar 

  48. Lee CM, Shrieve DC, Zempolich KA, Lee RJ, Hammond E, Handrahan DL, Gaffney DK. Correlation between human epidermal growth factor receptor family (EGFR, HER2, HER3, HER4), phosphorylated Akt (P-Akt), and clinical outcomes after radiation therapy in carcinoma of the cervix. Gynecol Oncol. 2005;99:415–21.

    Article  CAS  PubMed  Google Scholar 

  49. Loncaster JA, Cooper RA, Logue JP, Davidson SE, Hunter RD, West CM. Vascular endothelial growth factor (VEGF) expression is a prognostic factor for radiotherapy outcome in advanced carcinoma of the cervix. Br J Cancer. 2000;83:620–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  50. Guidi AJ, Abu-Jawdeh G, Berse B, Jackman RW, Tognazzi K, Dvorak HF, Brown LF. Vascular permeability factor (vascular endothelial growth factor) expression and angiogenesis in cervical neoplasia. J Natl Cancer Inst. 1995;87:1237–45.

    Article  CAS  PubMed  Google Scholar 

  51. Ferrara N, Hillan KJ, Gerber HP, Novotny W. Discovery and development of bevacizumab, an anti-VEGF antibody for treating cancer. Nat Rev Drug Discov. 2004;3:391–400.

    Article  CAS  PubMed  Google Scholar 

  52. Presta LG, Chen H, O'Connor SJ, Chisholm V, Meng YG, Krummen L, Winkler M, Ferrara N. Humanization of an anti-vascular endothelial growth factor monoclonal antibody for the therapy of solid tumors and other disorders. Cancer Res. 1997;57:4593–9.

    CAS  PubMed  Google Scholar 

  53. Monk BJ, Sill MW, Burger RA, Gray HJ, Buekers TE, Roman LD. Phase II trial of bevacizumab in the treatment of persistent or recurrent squamous cell carcinoma of the cervix: a gynecologic oncology group study. J Clin Oncol. 2009;27:1069–74.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  54. Tewari KS, Sill MW, Long HJ 3rd, Penson RT, Huang H, Ramondetta LM, Landrum LM, Oaknin A, Reid TJ, Leitao MM, Michael HE, Monk BJ. Improved survival with bevacizumab in advanced cervical cancer. N Engl J Med. 2014;370:734–43.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  55. Ishikawa M, Shibata T, Iwata T, Nishio S, Takada T, Suzuki S, Horie K, Kudaka W, Kagabu M, Tanikawa M, Kitagawa R, Takekuma M, Kobayashi H, Yaegashi N, Japan Clinical Oncology Group. A randomized phase II/III trial of conventional paclitaxel and carboplatin with or without bevacizumab versus dose-dense paclitaxel and carboplatin with or without bevacizumab, in stage IVB, recurrent, or persistent cervical carcinoma (JCOG1311): primary analysis. Gynecol Oncol. 2021;162:292–8.

    Article  CAS  PubMed  Google Scholar 

  56. Redondo A, Colombo N, McCormack M, Dreosti L, Nogueira-Rodrigues A, Scambia G, Lorusso D, Joly F, Schenker M, Ruff P, Estevez-Diz M, Irahara N, Donica M, Gonzalez-Martín A. Primary results from CECILIA, a global single-arm phase II study evaluating bevacizumab, carboplatin and paclitaxel for advanced cervical cancer. Gynecol Oncol. 2020;159:142–9.

    Article  CAS  PubMed  Google Scholar 

  57. Yamashita H, Murakami N, Asari T, Okuma K, Ohtomo K, Nakagawa K. Correlation among six biologic factors (p53, p21WAF1, MIB-1, EGFR, HER2, and Bcl-2) and clinical outcomes after curative chemoradiation therapy in squamous cell cervical cancer. Int J Radiat Oncol Biol Phys. 2009;74:1165–72.

    Article  CAS  PubMed  Google Scholar 

  58. Pérez-Regadera J, Sánchez-Muñoz A, De-la-Cruz J, Ballestín C, Lora D, García-Martín R, Mendiola C, Alonso L, Alba E, Lanzós E. Negative prognostic impact of the coexpression of epidermal growth factor receptor and c-erbB-2 in locally advanced cervical cancer. Oncology. 2009;76:133–41.

    Article  PubMed  Google Scholar 

  59. Monk BJ, Lopez LM, Zarba JJ, Oaknin A, Tarpin C, Termrungruanglert W, Alber JA, Ding J, Stutts MW, Pandite LN. Phase II, open-label study of pazopanib or lapatinib monotherapy compared with pazopanib plus lapatinib combination therapy in patients with advanced and recurrent cervical cancer. J Clin Oncol. 2010;28:3562–9.

    Article  CAS  PubMed  Google Scholar 

  60. Oaknin A, Friedman CF, Roman LD, D'Souza A, Brana I, Bidard FC, Goldman J, Alvarez EA, Boni V, ElNaggar AC, Passalacqua R, Do KTM, Santin AD, Keyvanjah K, Xu F, Eli LD, Lalani AS, Bryce RP, Hyman DM, Meric-Bernstam F, Solit DB, Monk BJ. Neratinib in patients with HER2-mutant, metastatic cervical cancer: findings from the phase 2 SUMMIT basket trial. Gynecol Oncol. 2020;159:150–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  61. Symonds RP, Gourley C, Davidson S, Carty K, McCartney E, Rai D, Banerjee S, Jackson D, Lord R, McCormack M, Hudson E, Reed N, Flubacher M, Jankowska P, Powell M, Dive C, West CML, Paul J. Cediranib combined with carboplatin and paclitaxel in patients with metastatic or recurrent cervical cancer (CIRCCa): a randomised, double-blind, placebo-controlled phase 2 trial. Lancet Oncol. 2015;16:1515–24.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  62. Farley J, Sill MW, Birrer M, Walker J, Schilder RJ, Thigpen JT, Coleman RL, Miller BE, Rose PG, Lankes HA. Phase II study of cisplatin plus cetuximab in advanced, recurrent, and previously treated cancers of the cervix and evaluation of epidermal growth factor receptor immunohistochemical expression: a gynecologic oncology group study. Gynecol Oncol. 2011;121:303–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  63. Mackay HJ, Tinker A, Winquist E, Thomas G, Swenerton K, Oza A, Sederias J, Ivy P, Eisenhauer EA. A phase II study of sunitinib in patients with locally advanced or metastatic cervical carcinoma: NCIC CTG trial IND.184. Gynecol Oncol. 2010;116:163–7.

    Article  CAS  PubMed  Google Scholar 

  64. Evaluate efficacy of the association nimotuzumab(HR3)/cisplatin vinorelbine on patients with cervical carcinoma (CIMAHOPE). https://ClinicalTrials.gov/show/NCT03413579.

  65. Study of nimotuzumab combined with concurrent chemoradiotherapy for locally advanced cervical cancer. https://ClinicalTrials.gov/show/NCT03469531.

  66. ENGOT-cx1/BGOG-cx1: 3 weekly carboplatin/paclitaxel with or without nintedanib in cervix cancer. https://ClinicalTrials.gov/show/NCT02009579.

  67. Apatinib and chemotherapy sequential treatment with cervical cancer. https://ClinicalTrials.gov/show/NCT03029013.

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  1. Department of Obstetrics and Gynecology, Kurume University School of Medicine, Kurume, Japan

    Shin Nishio

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    Daisuke Aoki

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Nishio, S. (2024). Chemotherapy for Advanced and Recurrent Cervical Cancer. In: Aoki, D. (eds) Recent Topics on Prevention, Diagnosis, and Clinical Management of Cervical Cancer. Comprehensive Gynecology and Obstetrics. Springer, Singapore. https://doi.org/10.1007/978-981-99-9396-3_14

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