Induction Chemotherapy Boosts Survival in Cervical Cancer

TOPLINE:

Induction chemotherapy followed by chemoradiotherapy improves 5-year overall survival rates in advanced cervical cancer from 72% to 80%. The treatment also enhances 5-year progression-free survival rates from 64% to 72%.

METHODOLOGY:

• Researchers conducted a multicenter, randomized phase 3 INTERLACE trial to evaluate whether short-course induction chemotherapy before chemoradiotherapy is more effective than chemoradiotherapy alone.
• A total of 500 adults with locally advanced cervical cancer were randomly assigned to receive either standard chemoradiotherapy alone or induction chemotherapy followed by chemoradiotherapy.
• Induction chemotherapy consisted of weekly intravenous carboplatin and paclitaxel for 6 weeks, followed by standard cisplatin-based chemoradiotherapy.
• Primary endpoints were progression-free survival and overall survival, with a median follow-up of 67 months.
• The trial, which involved patients from 32 medical centers in Brazil, India, Italy, Mexico, and the United Kingdom, adhered to the principles of the Declaration of Helsinki, Good Clinical Practice guidelines, and applicable local regulatory requirements.

TAKEAWAY:

• Induction chemotherapy followed by chemoradiotherapy significantly improved 5-year progression-free survival rates from 64% to 72% (hazard ratio [HR], 0.65; 95% CI, 0.46-0.91; P = .013).
• The 5-year overall survival rates increased from 72% to 80% with induction chemotherapy followed by chemoradiotherapy (HR, 0.60; 95% CI, 0.40-0.91; P = .015).
• Grade 3 or greater adverse events were more common in the induction chemotherapy group (occurring in 59% of these patients) than in the chemoradiotherapy alone group (occurring in 48% of these patients).
• Distant only relapses were less frequent in the induction chemotherapy group (occurring in 7%) than in the chemoradiotherapy alone group (occurring in 12%; P = .015).

IN PRACTICE:

“Induction chemotherapy delivered according to the INTERLACE protocol should be included in clinical guidelines as an option to improve outcomes in patients with locally advanced cervical cancer. This approach could be included in the design of future clinical trials of immunotherapy or other targeted drugs in the front-line setting,” the authors of the study wrote.

SOURCE:

This study was led by Mary McCormack, PhD, of University College London Hospitals NHS Foundation Trust in London, England. It was published online on October 14 in The Lancet.

LIMITATIONS:

The study’s limitations included the exclusion of patients with FIGO 2008 stage IIIA disease and para-aortic nodes, which may have limited the generalizability of the findings. Additionally, the long recruitment duration of 10 years may have influenced the results. The study’s adherence to strict radiotherapy quality assurance requirements also posed challenges.

DISCLOSURES:

McCormack disclosed receiving payment or honoraria from MSD, Eisai, GSK, Roche, and Medscape Medical News. Additional disclosures are noted in the original article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.