Pemetrexed-cisplatin combined with antiangiogenesis drug in recurrent and metastatic cervical carcinoma: A case report and literature review

Pemetrexed is an antifolate agent which has shown activity on various tumors. But no result has been reported on the clinical efficacy and toxicity of pemetrexed combined with antiangiogenesis drug in patients with cervical cancer. Apatinib is an oral antiangiogenesis drug in cervical cancer, which has been reported efficacy and safety in cervical cancer. Here, we present a 50-year-old woman who was diagnosed with recurrent and metastatic cervical adenocarcinoma two years after postoperative adjuvant radiotherapy. After pathology and magnetic resonance imaging confirmed the recurrence and metastasis, the patient was administered pemetrexed 500 mg/m2 and cisplatin 50 mg/m2 on day 1, cycled every three weeks for four cycles. Then add apatinib 500 mg/d from day 1 to day 21 combined with pemetrexed and cisplatin for two cycles, followed by pemetrexed 500 mg/m2 on day 1 combined with apatinib every 21 days per cycle for two cycles. Finally, a single dose of apatinib is a maintenance therapy. According to the Response Evaluation Criteria In Solid Tumors (RECIST) 1.1 standard, she was confirmed as Partial Response (PR). Now, the Progression-Free Survival (PFS) of the patient has been 21 months. No grade III-IV adverse effects have been found. In conclusion, pemetrexed-cisplatin combined with antiangiogenesis drug might be an effective and mild toxic treatment for patients with recurrent or metastatic cervical carcinoma. Further prospective clinical trials are needed to verify this conclusion.