Trial involved short course of induction chemotherapy before standard chemoradiation treatment
Use of existing drugs before the standard treatment for cervical cancer could lead to a 35% reduction in the risk of the disease recurring or causing death, the results of a study suggest.
By Haroon Siddique
Researchers assessed whether a short course of induction chemotherapy (IC), using cheap, already approved drugs to destroy as many cancer cells as possible, could reduce rates of relapse and death if administered before chemoradiation (CRT), a combination of chemotherapy and radiotherapy.
Cancer Research UK said the results were “remarkable”.
The trial found that after five years, 80% of those who received IC plus CRT were alive and 73% had not seen their cancer return or spread. In those who just had the standard treatment, 72% were alive and 64% had not seen their cancer return or spread.
Dr Mary McCormack, the lead investigator of the trial from University College London’s Cancer Institute and University College London hospital, said: “Our trial shows that this short course of additional chemotherapy delivered immediately before the standard CRT can reduce the risk of the cancer returning or death by 35%. This is the biggest improvement in outcome in this disease in over 20 years.
“I’m incredibly proud of all the patients who participated in the trial; their contribution has allowed us to gather the evidence needed to improve treatment of cervical cancer patients everywhere.”
Cervical cancer is most commonly diagnosed in women in their early 30s, with about 3,200 new cases each year in the UK.
CRT has been the standard treatment since 1999. Despite improvements in radiation therapy techniques, cancer returns in up to 30% of cases.
According to Cancer Research UK, which funded the study, the five-year survival rate for cervical cancer is about 70%.
Over 10 years, 500 patients took part in the randomised, controlled trial at hospitals in the UK, Mexico, India, Italy and Brazil. The study has not been peer-reviewed.
Participants had been diagnosed with cervical cancer that was large enough to be seen without a microscope but had not spread to other parts of the body.
The drugs required for IC – carboplatin and paclitaxel – are cheap, accessible and already approved for use in patients, so they could be incorporated into standard of care treatment relatively quickly, the researchers said.
Prof Jonathan Ledermann, a senior author of the results from UCL Cancer Institute, said the findings were “an important advance in treatment”.
Health professional after performing a smear test, with a woman in the background.
Dr Iain Foulkes, the executive director of research and innovation at Cancer Research UK, said: “Timing is everything when you’re treating cancer. The simple act of adding induction chemotherapy to the start of chemoradiation treatment for cervical cancer has delivered remarkable results in this trial.
“A growing body of evidence is showing the value of additional rounds of chemotherapy before other treatments like surgery and radiotherapy in several other cancers. Not only can it reduce the chances of cancer coming back, it can be delivered quickly using drugs already available worldwide.
“We’re excited for the improvements this trial could bring to cervical cancer treatment and hope short courses of induction chemotherapy will be rapidly adopted in the clinic.”
The preliminary results were presented at the European Society for Medical Oncology congress on Sunday.