New Study Shows Induction Chemotherapy Can Improve Cervical Cancer Survival Rates

According to the World Health Organization, cervical cancer is the fourth most common type of cancer in women, being caused in a proportion of over 95% by infection with the Human Papilloma Virus. In the treatment of advanced cervical cancer (stages III-IVa), the standard therapy from 1999 to the present is a combination of radiotherapy and chemotherapy (CRT), administered simultaneously. Despite improvements in irradiation technique, the risk of cancer recurrence is approximately 30%, with a 5-year survival rate of approximately 70%.

In a study presented at the congress European Society for Medical Oncology 2023it was shown that one cycle of chemotherapy before CRT can reduce the risk of death or disease recurrence by about 35% in patients diagnosed with locally advanced cervical cancer, without distant metastases. The phase III INTERLACE study analyzed the therapeutic benefit that a course of induction chemotherapy before chemoradiation brings to patients with locally advanced cervical cancer.

Patients were randomized to receive standard CRT consisting of external beam radiation with weekly cisplatin and brachytherapy or an initial 6-week course of carboplatin and paclitaxel followed by standard CRT. After 5 years, 80% of patients who received chemotherapy and CRT survived, and 73% had no cancer recurrence or extension. Among patients who received standard therapy, 72% were alive, with 64% free of recurrence or metastases.

Medicines required for induction chemotherapy, ca paclitaxel and carboplatin are cheap, affordable, and already approved to be given to patients, so they can be introduced into the standard of care relatively quickly.

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“Our study shows that this short course of additional chemotherapy given immediately before standard CRT can reduce the risk of recurrence or death by 35%. This is the biggest improvement in the prognosis of the disease in 20 years,” said study leader Dr Mary McCormack from the UCL Cancer Institute and UCLH in a article published in News Wise.

The INTERLACE study included 500 patients from hospitals in the UK, Mexico, India, Italy and Brazil over a 10-year period, with an average age of 46. The condition for participation was a diagnosis of cervical squamous cell carcinoma, adenocarcinoma or adenosquamous carcinoma, FIGO stage IB2-IVa. In order to receive radical CRT, carboplatin, and paclitaxel, renal, hepatic, and hematogenous functions had to be adequate. Distant metastases were not compatible with the study, but patients with FIGO stage IB1 and positive lymph nodes were eligible to participate.

They were randomly divided into two groups, one group receiving standard CRT treatment (cisplatin chemotherapy followed by radiotherapy) for 5 weeks, and the other group receiving 6 weeks of induction chemotherapy (cisplatin and paclitaxel) followed by standard treatment of CRT.

According to the authors of the study, these findings may lead to a significant improvement in the treatment of cervical cancer, with the adoption of this approach as a therapeutic standard in the shortest possible time.

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2023-11-07 15:44:14
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