Neoadjuvant chemotherapy in locally advanced cervical cancer: two randomized studies

Date 24 November 2018
Event ESMO Asia 2018 Congress
Session Poster display - Cocktail
Topics Cervical Cancer
Presenter zilola Olimova
Citation Annals of Oncology (2018) 29 (suppl_9): ix79-ix86. 10.1093/annonc/mdy436
Authors Z.A. Olimova
  • Outpatient Department, City Oncology Centre, 100000 - Tashkent/UZ

Abstract

Background

The objective of this phase II study was to assess the efficacy and toxicity of vinorelbine + carboplatini in the treatment of chemonaïve cervical cancer patients.

Methods

Between August 2014 and January 2016, 184 patients with squamous cell carcinoma of the cervix, FIGO stage II B IV A were randomized (study 1) to receive either two cycles of intravenous (i.v.) vinorelbine 30 mg/m2 infused over 20 min on day 1, 8, 15 every 4 weeks; carboplatin 360 mg/m2 by intravenous injection on day 1 every 4 weeks (VP). Chemotherapy (CT) followed by radiotherapy (RT). No prior chemotherapy or radiotherapy was allowed.

Results

'CT-RT Group' n = 94 or RT alone, RT Group n = 90. In the 'CT-RT Group', of evaluable 89 patients, 64 responded: complete response (CR) four (4.5%) and partial response (PR) 60 (67.5%). Of the remaining 25 patients 23 had stable disease and two progressed. Eighty of 89 patients completed RT as planned. Following RT 56 (70%) achieved CR, 19 (23.7%) had residual disease and five (6.3%) had progressed. Patients aged > 45 and those with Hb > 10 gm/dL had significantly better response to CT. Further, CT responders had a better response to RT; 83% (49/59) vs 33.3% (seven/21), p < 0.01. In the 'RT Group' 88 patients were evaluable; 61 (69.3%) patients achieved CR, 25 had residual disease and two progressed. The estimated overall survival at 48 months in the 'CT-RT Group' and the 'RT Group' is 38% +2.01 (SE) and 36% +1.85 (SE), p = 0.59 respectively. In a subsequent randomized study (study 2) 36 patients with stage III B cervical cancer received two cycles of VP (as above) followed by RT vs 36 patients who received RT alone. In the 'CT-RT Group' 29 patients responded; CR-8 (22.2%), PR-21 (58.3%). Six patients had no response to CT and one patient died of CT toxicity. Following RT-24 of 35 (68-6%) patients achieved CR, eight had residual disease and three patients progressed while on RT. In the 'RT Group'-11 of 36 (58.4%) achieved CR, 8 had residual disease and six progressed. Estimated survival was 71% in the 'CT-RT Group' and 39% in the 'RT Group', p = ns.

Conclusions

In conclusion, VP CT prior to RT in patients with locally advanced cervical cancer results in a high response rate. Response to CT predicts response to RT.

Editorial acknowledgement

Clinical trial identification

Legal entity responsible for the study

The Tashkent City Branch of the Republican Specialized Scientific and Practical Medical Center of Oncology and Radiology.

Funding

Has not received any funding.

Disclosure

The author has declared no conflicts of interest.