Neoadjuvant chemotherapy with cisplatin and gemcitabine followed by chemoradiation with cisplatin in locally advanced cervical cancer: A phase II, prospective, randomized, trial.

Silva, Samantha; Bonadio, Renata R.C. Colombo; Gabrielli, Flavia; Aranha, Andrea; Genta, Maria Luiza Nogueira Dias; Miranda, Vanessa da Costa; Freitas, Daniel Salvatore de; Filho, Elias Abdo; Ferreira, Patrícia Alves; Kalil, Karime; Scaranti, Mariana; Estevez-Diz, Maria Del Pilar

doi:10.1200/jco.2018.36.15_suppl.5523

Cited by 4 publications

(2 citation statements)

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“…In the 2018 ASCO Meeting, an abstract investigating whether NAC prior to definitive CRT improves treatment outcomes (NCT01973101) was posted [60]. Silva et al [60] randomized 107 patients with locally advanced cervical cancer as follows: those treated with three cycles of NAC with cisplatin (50 mg/m 2 ) and gemcitabine (1,000 mg/m 2 ) followed by standard CRT plus cisplatin (40 mg/m 2 ) administered weekly for 6 weeks and those treated with standard CRT. The primary endpoint was 3-year PFS, and the secondary endpoints were response rate, OS, and toxicities.…”

Section: Radiation Oncologymentioning

confidence: 99%

Major clinical research advances in gynecologic cancer in 2018

et al. 2019

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In this review, we summarized 14 major clinical advances in gynecology which occurred in 2008. For cervical cancer, clinical impact of HPV vaccine, prognostic value of imaging during radiotherapy, and oncologic/obstetric outcomes of fertility-sparing surgery were chosen. For uterine cancer, optimal method of adjuvant radiotherapy in intermediaterisk patients, extent of lymph node dissection, outcome of robot-assisted staging surgery, new standard chemotherapy regimen for leiomyosarcoma were selected. For ovarian cancer, recent changes in adjuvant therapy, feasibility of neoadjuvant chemotherapy, prediction of optimal secondary cytoreduction, studies on new biomarkers, advances in screening and treatment of women with BRCA mutations were included. For other cancers, the safety of sentinel lymph node dissection in vulvar cancer and chemotherapy regimens for low-risk gestational trophoblastic tumors were reviewed.

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Section: Radiation Oncologymentioning

confidence: 99%

Major clinical research advances in gynecologic cancer in 2018

et al. 2019

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“…In the last 7 years the use of systemic CT beyond the concomitant phase of CT and RT (RTCT) has been studied as a treatment intensification strategy. Initial studies with induction CT prior to RTCT have not shown promising results leading to questions about the novel drug combinations and timing of therapy [ 11 , 12 ]. Two phase III trials have shown an OS benefit with the addition of consolidation CT after concomitant RTCT [ 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

The Impact of Addition of Consolidation Chemotherapy to Standard Cisplatin-Based Chemoradiotherapy in Uterine Cervical Cancer: Matter of Distant Relapse

Fabri

Queiroz

Mantoan

et al. 2019

Journal of Oncology

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Background. Treatment of advanced uterine cervical cancer has advanced little in the last 15 years. Although two phase III trials showed survival benefit with the addition of consolidation chemotherapy (CT) after cisplatin-based chemoradiotherapy (RTCT), it is not considered standard of care. We aimed to evaluate the benefit of consolidation CT compared to no additional treatment in patients treated with RTCT. Methods. This is a retrospective study including 186 patients with FIGO stage IB2, IIA2, or IIB to IVB (paraaortic lymph nodes only) uterine cervical cancer who were treated with standard RTCT alone or RTCT followed by consolidation CT. Overall survival (OS), progression free survival (PFS), and the risk of distant and local relapses were compared between the two treatment groups. Results. At 3 years OS was 91% versus 82.3% (p=0.027), PFS 84.3% versus 54.4% (p=0.047), and distant metastasis free survival (DMFS) 80.4% versus 62.5% (p=0.027) in favor of the consolidation CT group. Multivariate analysis confirmed the benefit of consolidation CT. There was no difference in locoregional free survival (LRFS). Positive lymph node was related to a higher risk of distant relapse. In the lymph node positive subgroup consolidation CT resulted in longer OS (p=0.050), PFS (p=0.014), and DMFS (p=0.022); in the lymph node negative subgroup there was no benefit from consolidation CT. Conclusions. Use of consolidation CT resulted in longer OS and PFS, mostly due to control of distant relapses. Patients at higher risk of distant relapse showed the greatest benefit. This data generates a hypothesis that could help to better select patients to consolidation CT.

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