A Randomized Phase III Trial Of Paclitaxel Plus Cisplatin Versus Vinorelbine Plus Cisplatin Versus Gemcitabine Plus Cisplatin Versus Topotecan Plus Cisplatin In Stage IVB, Recurrent Or Persistent Carcinoma of the Cervix

Inclusion Criteria

DISEASE CHARACTERISTICS:

- Histologically confirmed squamous cell carcinoma, adenosquamous carcinoma, or
adenocarcinoma of the cervix

- Stage IVB, recurrent, or persistent disease

- Not amenable to curative surgery and/or radiotherapy

- At least 1 unidimensionally measurable lesion

- At least 20 mm by palpation, plain x-ray, CT scan, or MRI OR at least 10 mm by
spiral CT scan

- Biopsy confirmation required if lesion is less than 30 mm

- Target lesion must be outside of a previously irradiated field

- No craniospinal metastases

PATIENT CHARACTERISTICS:

Age

- 18 and over

Performance status

- GOG 0-1

Life expectancy

- Not specified

Hematopoietic

- Absolute neutrophil count at least 1,500/mm^3

- Platelet count at least 100,000/mm^3

Hepatic

- Bilirubin no greater than 1.5 times normal

- Alkaline phosphatase no greater than 3 times normal

- AST no greater than 3 times normal

Renal

- Creatinine ≤ 1.2 mg/dL OR

- Creatinine > 1.2 mg/dL but < 1.5 mg/dL AND creatinine clearance ≥ 50 mL/min

- No bilateral hydronephrosis not alleviated by ureteral stents or percutaneous
drainage

Other

- Not pregnant or nursing

- Fertile patients must use effective contraception

- No prior or concurrent malignancy within the past 5 years except nonmelanoma skin
cancer

- No prior malignancy whose treatment contraindicates the current study therapy

- No concurrent clinically significant infection

PRIOR CONCURRENT THERAPY:

Biologic therapy

- No concurrent cytokines

Chemotherapy

- At least 6 weeks since prior chemoradiotherapy and recovered

- No prior chemotherapy (except when concurrently administered with radiotherapy)

Endocrine therapy

- Not specified

Radiotherapy

- See Disease Characteristics

- See Chemotherapy

- At least 3 weeks since prior radiotherapy and recovered

Surgery

- Recovered from prior surgery