Clinical activity of platinum rechallenge with nedaplatin plus irinotecan in recurrent cervical cancer following prior platinum-based systemic chemotherapy: a single-center retrospective study.

BACKGROUND: Treatment options remain limited for patients with recurrent cervical cancer following prior platinum-based systemic chemotherapy. Despite the activity of nedaplatin plus irinotecan in recurrent cervical cancer, its clinical value as a platinum rechallenge regimen following prior platinum-based systemic chemotherapy remains unclear. This study examined the efficacy and safety of this combination therapy in this setting. METHODS: Patients with recurrent cervical cancer who received at least 1 cycle of nedaplatin plus irinotecan after recurrence or progression following prior platinum-based systemic chemotherapy at Jichi Medical University Hospital between January 2018 and December 2025 were retrospectively analyzed. Treatment efficacy and safety were evaluated, and survival outcomes were estimated using the Kaplan-Meier method. RESULTS: This study included 26 patients. The median platinum-free interval was 3 months, and 21 patients received nedaplatin plus irinotecan as a second-line platinum-containing systemic chemotherapy. The objective response rate among patients with measurable disease was 23.8%, whereas the disease control rate among all evaluable patients was 53.8%. The median progression-free survival was 5.0 months, whereas the median overall survival was 22.5 months. Grade ≥ 3 hematologic adverse events included neutropenia in 15 patients, anemia in 9, and thrombocytopenia in 5. No treatment-related death occurred. CONCLUSIONS: Nedaplatin plus irinotecan demonstrated clinically meaningful activity with manageable toxicity in selected patients with recurrent cervical cancer following prior platinum-based systemic chemotherapy. Platinum rechallenge may be a potential treatment option in this setting, although further studies are warranted to identify patients most likely to benefit.