Chemoradiotherapy Plus Adjuvant Chemotherapy for High-Risk Cervical Cancer After Radical Hysterectomy
According to results phase 3 trial, the addition of systemic chemotherapy after chemoradiotherapy did not improve disease-free survival (DFS) or overall survival (OS) among patients with cervical cancer with high-risk factors following radical hysterectomy.
These data will be presented by Anuja Jhingran, MD, The University of Texas, MD Anderson Cancer Center, Houston, Texas, at the 2024 American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago, Illinois.
This international phase 3 included 212 patients with clinical stage IA2, IB, or IIA cervical cancer with at least 1 high-risk factor following radical hysterectomy (positive pelvic nodes, positive parametrium, and/or positive para-aortic nodes). Patients were randomized on a 1-to-1 basis to receive either chemoradiotherapy (chemoradiotherapy arm; n = 109) or chemoradiotherapy followed by 4 cycles of adjuvant chemotherapy with paclitaxel and carboplatin (adjuvant chemo arm, n = 103). The primary end point of the trial was DFS with secondary end points including OS and adverse events.
With a median follow-up duration of 4.5 years, the 4-year DFS estimates were 76% in the chemoradiotherapy arm and 77% in the adjuvant chemo arm (hazard ratio [HR]; 1.05; 90% confidence interval [CI], 0.65 to 1.68; P = .56). The multivariate analysis found receiving vaginal brachy, radiation dose ≥50 Gy, and adenocarcinoma histology were associated with a worse DFS. The estimated 4-year OS was 87% in the chemoradiotherapy arm and 89% in the adjuvant chemo arm (HR, 0.91; 90% CI, .49 to 1.69; 1-sided log-rank P = .40).
Source:
Jhingran A. Adjuvant chemotherapy following concurrent chemoradiation (CRT) in patients with high-risk early-stage cervical carcinoma following radical hysterectomy: Results of NRG oncology/RTOG 0724/GOG-0724. Presented at the ASCO Annual Meeting. May 31 – June 4, 2024; Chicago, IL. Abstract #5504
