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

Fabri, Vanessa Alves; Queiroz, Ana Carolina Matos; Mantoan, Henrique; Sanches, Solange Moraes; Guimarães, Andréa Paiva Gadêlha; Ribeiro, Adriana Regina G.; Souza, Ronaldo Pereira; Maya, Joyce Maria Lisboa; Santos, Elizabeth Santana Dos; Castro, Fabricio S.; Lima, João Paulo Nogueira; Chen, Michael; Baiocchi, Glauco; Costa, Alexandre André Balieiro Anastácio da

doi:10.1155/2019/1217838

Cited by 19 publications

(17 citation statements)

References 21 publications

(21 reference statements)

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“…Currently, cisplatin (DDP)-based concurrent chemoradiotherapy is the standard treatment for locally advanced CC 6 . A study found that consolidation chemotherapy after cisplatin-based chemoradiotherapy can control distant relapse and improve overall survival (OS) and progression-free survival 7 . However, cisplatin resistance remains a serious problem during the treatment of CC, which greatly restricts the clinical application and efficacy of cisplatin 8 .…”

Section: Introductionmentioning

confidence: 99%

Low GAS5 expression may predict poor survival and cisplatin resistance in cervical cancer

et al. 2020

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Cisplatin resistance is a major challenge in cervical cancer (CC) chemotherapy. Growth arrest‐specific 5 (GAS5) has been reported to be a tumour suppressor gene in CC. However, the mechanism of GAS5 in chemoresistance remains undetermined. Our research evaluated GAS5 expression in normal and CC tissues by qPCR and in situ hybridization (ISH). Statistical analysis was conducted to analyse the association of GAS5 expression with survival. Biochemical methods were used to screen upstream and downstream regulators of GAS5. Then, interactions were confirmed by ChIP, RNA pull-down, RNA immunoprecipitation (RIP), dual-luciferase reporter and real-time PCR assays. The cisplatin sensitivity of GAS5-overexpressing CC cells was demonstrated in vitro and in vivo. The results showed that low GAS5 expression was correlated with poor overall survival. Mechanistically, GAS5 was transcriptionally modulated by P-STAT3 and served as a competing endogenous RNA (ceRNA) of miR-21 to indirectly affect cisplatin sensitivity through PDCD4 regulation in CC cells. Animal studies confirmed that GAS5 enhanced cisplatin sensitivity and promoted PDCD4 expression in vivo. GAS5 was regulated by P-STAT3 and affected the sensitivity of CC to cisplatin-based chemotherapy through the miR-21/PDCD4 axis. This result may provide new insight into cisplatin-based therapy.

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Section: Introductionmentioning

confidence: 99%

Low GAS5 expression may predict poor survival and cisplatin resistance in cervical cancer

et al. 2020

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“…Subgroup-analysis of the randomized controlled trial by Duenas-Gonzales et al showed that patients with Stage III–IVA, tumors ≥5 cm and of non-adenocarcinoma histotype had benefitted the most from adjuvant treatment [ 20 ]. The contrary was found in the study by Fabri et al: stage ≥IIIA had a significantly worse overall survival despite adjuvant platinum–pyrimidine in multivariable analysis [ 21 ]. Kim et al found that adjuvant platinum–pyrimidine and tumor characteristics were not significantly related to overall survival and disease-free survival in univariable analyses [ 22 ].…”

Section: Discussionmentioning

confidence: 68%

“…In nine studies, adjuvant systemic therapy consisted of 1–3 cycles cisplatin and a pyrimidine antagonist. This was 5-fluorouracil in five [ 18 , 19 , 22 , 23 , 24 , 35 ], gemcitabine in four studies [ 11 , 20 , 21 , 34 , 37 ]. In 12 studies, adjuvant systemic therapy was 3–6 cycles of a platinum derivate (carboplatin [ 17 , 25 , 27 , 29 , 30 , 31 , 32 , 33 , 40 ], cisplatin [ 49 ], cisplatin or carboplatin [ 28 ] or nedaplatin [ 32 ] with a taxane (paclitaxel in 11 [ 17 , 25 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 40 , 50 ], docetaxel in 1 [ 49 ]).…”

Section: Resultsmentioning

confidence: 99%

Adjuvant Systemic Therapy after Chemoradiation and Brachytherapy for Locally Advanced Cervical Cancer: A Systematic Review and Meta-Analysis

Horeweg

Mittal

Gradowska

et al. 2021

Cancers

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Background: Standard of care for locally advanced cervical cancer is chemoradiation and brachytherapy. The addition of adjuvant systemic treatment may improve overall survival. A systematic review and meta-analysis was conducted to summarize evidence on survival outcomes, treatment completion and toxicity. Methods: PubMed, EMBASE and Web of Science were systematically searched for relevant prospective and retrospective studies. Two authors independently selected studies, extracted data and assessed study quality. Pooled hazard ratios for survival endpoints were estimated using random effect models. Weighted averages of treatment completion and toxicity rates were calculated and compared by the Fisher exact test. Results: The search returned 612 articles; 35 articles reporting on 29 different studies on adjuvant chemotherapy or immunotherapy were selected for systematic review. Twelve studies on an adjuvant platinum–pyrimidine antagonist or platinum–taxane were included for meta-analysis. The pooled hazard ratios for overall survival were 0.76 (99%CI: 0.43–1.34, p = 0.22) and 0.47 (99%CI: 0.12–1.86, p = 0.16) for the addition of, respectively, a platinum–pyrimidine antagonist or platinum–taxane to chemoradiation and brachytherapy. Completion rates were 82% (95%CI: 76–87%) for platinum–pyrimidine antagonist and 74% (95%CI: 63–85%) for platinum–taxane. Severe acute hematological and gastro-intestinal toxicities were significantly increased by adding adjuvant chemotherapy to chemoradiation and brachytherapy. Conclusions: The addition of adjuvant platinum–pyrimidine antagonist or platinum–taxane after chemoradiation and brachytherapy does not significantly improve overall survival, while acute toxicity is significantly increased. These adjuvant treatment strategies can therefore not be recommended for unselected patients with locally advanced cervical cancer.

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“…Compared with concurrent radiotherapy and chemotherapy, neoadjuvant chemotherapy plus surgery and post-operative supplementary radiotherapy have different complications. Fabri [13] has reported no difference in adverse reactions between neoadjuvant chemotherapy and concurrent chemoradiotherapy. Dang et al [14] compared the complications of concurrent radiotherapy and chemotherapy with that of radiotherapy alone and found that concurrent radiotherapy and cisplatin-based chemotherapy could increase the therapeutic effect in cervical cancer patients and significantly improve the therapeutic benefit without increasing adverse reactions.…”

Section: Discussionmentioning

confidence: 98%

Efficacy and prognostic factors of concurrent chemoradiotherapy in patients with stage Ib3 and IIa2 cervical cancer

et al. 2020

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Objectives: We investigated the efficacy, side effects, and prognostic factors of concurrent chemoradiotherapy for patients with stage Ib3-IIa2 cervical cancer. Material and methods: We conducted a retrospective analysis of clinicopathologic data from 73 patients with stage Ib3-IIa2 cervical cancer who received concurrent chemoradiotherapy from January 2008 to December 2013 in our hospital. Overall response and disease control rates were used to evaluate short-term outcomes; the 3-year and 5-year disease-free survival and overall survival were used to evaluate long-term efficacy. Toxicity reactions and prognostic factors were recorded. Results: With concurrent chemoradiotherapy, overall response and disease control rates were 91.78% and 97.26%, respectively. The 3-year disease-free and overall survival were 80.82% and 83.56%; the 5-year disease-free and overall survival were 75.34% and 79.45%, respectively. All side effects were tolerated and potentially alleviated by symptomatic treatment. Tumor pathological type, differentiated degree, primary tumor size and squamous cell carcinoma antigen levels before and after treatment were closely related to survival (univariate analysis; p < 0.05). Pathological type, primary tumor size and squamous cell carcinoma antigen levels one month after treatment were independent prognostic factors for long-term outcome (multivariate analysis). Conclusions: Short-and long-term efficacy of concurrent chemoradiotherapy for stage Ib3-IIa2 cervical cancer is well-determined and tolerable. Patients with adenocarcinomas, tumor diameter ≥ 5 cm and squamous cell carcinoma antigen levels ≥ 1.5 ng/mL (one month after treatment) had poor prognosis and should be assessed further.

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

Cited by 19 publications

References 21 publications

Low GAS5 expression may predict poor survival and cisplatin resistance in cervical cancer

Low GAS5 expression may predict poor survival and cisplatin resistance in cervical cancer

Adjuvant Systemic Therapy after Chemoradiation and Brachytherapy for Locally Advanced Cervical Cancer: A Systematic Review and Meta-Analysis

Efficacy and prognostic factors of concurrent chemoradiotherapy in patients with stage Ib3 and IIa2 cervical cancer

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