Meta-analysis showing that early response to neoadjuvant chemotherapy predicts better survival among cervical cancer patients

Abstract

This study was designed to identify the prognostic value of early response to neoadjuvant chemotherapy (NACT) for long-term survival of cervical cancer patients. We searched Pubmed and EMBASE for studies published through July 2016 on outcomes of cervical patients that received NACT. Eight studies involving 825 cervical cancer patients were ultimately included in our meta-analysis. We pooled the hazard ratios (HR) according to random-effects models and used funnel plots with Egger's and Begg's tests to explore potential publication bias. The HR between early response and 1-year overall survival (OS) was 3.60 (95% CI 1.93–6.72; I2 = 0). Similar results were found in the analysis of 3-year OS (HR 3.34; 95% CI 2.28–4.90; I2 = 0) and 5-year OS (HR 3.44; 95% CI 2.40–4.94; I2 = 0). Sensitivity analysis showed that all of the pooled results were robust, and all logHRs had confidence limits > 0. Our findings indicate that early response is associated with long-term survival, and responders achieved a higher survival rate than non-responders.

Multi‐institutional phase II study of neoadjuvant irinotecan and nedaplatin followed by radical hysterectomy and the adjuvant chemotherapy for locally advanced, bulky uterine cervical cancer: A Kansai Clinical Oncology Group study (KCOG‐G1201)

“…A recent meta‐analysis that included 825 patients with locally advanced cervical cancer recently showed that responder had favorable prognosis according to the 3‐year and 5‐year OS . In the current study, the RFS was 94.7% at 2 years and at 5 years.…”

Radical Hysterectomy After Neoadjuvant Chemotherapy for Locally Bulky-Size Cervical Cancer: A Retrospective Comparative Analysis between the Robotic and Abdominal Approaches

“…Thus, NACT is an acceptable and effective procedure for selected patients with LBS-CC, although the analysis did not support advantages in survival (DFS, PFS, and OS) of patients with LBS-CC treated with NACT [54]. In fact, the impact on survival after NACT is still highly debatable, with no consensus about whether it can result in better outcomes [28,29,30,35,36,54,55,56,57,58,59]. Accordingly, the term “acquired treatment response” seems important.…”

“…Moreover, the pathological response also predicted favorable outcomes such as DFS (HR 3.61, 95% CI 2.0–6.52) and OS (HR 5.45, 95% CI 3.42–8.7) [57]. Another meta-analysis further suggested the importance of an early response, because an early response to NACT is associated with favorable outcomes [58]. However, it is difficult to define “early response”.…”

Neoadjuvante Chemotherapiekonzepte beim Zervixkarzinom

“…Auch wenn die Studienergebnisse beim Zervixkarzinom eher darauf hindeuten, dass sich das klinische Ergebnis bezogen auf patientenrelevante Parameter wie PFS oder OS nicht verbessertund insbesondere das PFS zum Teil verschlechtert wird, sahen zumindest Chen et al in ihrer Metaanalyse in einigen Subgruppen einen Benefit für das Gesamtüberleben [1]. Patientinnen, die auf die neoadjuvante Therapie sehr gut angesprochen hatten, wiesen einen signifikanten Überlebensvorteil auf.…”