Concurrent Chemoradiation with Nano- Paclitaxel and Carboplatin in Locally Advanced Cervical cancer - A Study at Quaternary Care Medical Center

Date 24 November 2018
Event ESMO Asia 2018 Congress
Session Poster display - Cocktail
Topics Cervical Cancer
Radiation Oncology
Presenter Prasad Eswaran
Citation Annals of Oncology (2018) 29 (suppl_9): ix79-ix86. 10.1093/annonc/mdy436
Authors P. Eswaran, S. Kalyan, J. Crystal
  • Medical Oncologist, MIOT INTERNATIONAL HOSPITAL, 600116 - Chennai/IN

Abstract

Background

The standard of care for concurrent chemoradiation in cervical cancer has been Cisplatin since the NCI alert in 1999. No advancements had been made over these 19 years. There is a imminent need for change in medications to improve response rates and overall survival. We tried using Nano-Paclitaxel as additional radiosensitizing drug, to increase intra tumoural penetration and antiangiogenic agent in the management of locally advanced cervical cancer.

Methods

25 patients were recruited from June 2017 to June 2018 from FIGO stage IIb to IV A. Sample sizes were IIA = 2, IIB = 15, IIIB = 6, IVA = 1 and Vault recurrence = 1. Carboplatin was given at standard dose of 2 AUC. Nano-Paclitaxel was given at dose of 125 mg/m2. Radiation was delivered with IGRT technique 50 Gy/25 fractions followed by 3 fractions of Brachytherapy to a total dose of 80 - 90Gy. Immediate response rates, toxicity profile (as per CTCAE V.5) and tolerability was evaluated in this pilot study. Disease Free Survival and Overall survival will be evaluated at 1, 2 and 3 years.

Results

All patients achieved complete response (CR 100%) at the end of external beam therapy. Most common toxicity was diarrhea - Grade 3 = 2 (8%), Grade 2 = 6 (24%), Grade 1 = 3 (12%). Grade 2 anemia (Hb < 10gm%) was present in 5 (20%) during RT. Blood transgusion were given to maintain Hb > 10gm%. 1 (4%) grade 3 and 4 (16%) grade 2 neutropenia present. Fatigue was most common complaint among all patients (Grade 2 -100%) duing weekly evaluation. Total duration of external beam therapy was within 6 weeks. 24 patients completed in less than 40 days. 1 patient completed in 44 days due to grade 3 neutropenia and diarrhea - Range 32 to 44 (Median - 36 days).

Conclusions

Nanopaclitaxel and Carboplatin along with radiation therapy is feasible, tolerated and clinically implementable without undue delay in days of radiation. This has to be evaluated in randomized trials for better results and survival data. Survival data will be presented in upcoming meetings.

Editorial acknowledgement

Clinical trial identification

Legal entity responsible for the study

Prasad Eswaran.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.