New cervical cancer treatment cuts risk of death from disease, according to trial results
Adding a six-week course of chemotherapy to the standard course of treatment for locally advanced cervical cancer resulted in a significant increase in survival rates, .
The study, published Monday in the journal The Lancet, involved 500 patients from 32 medical centers in Brazil, India, Italy, Mexico and the U.K. who were randomly assigned into two groups between 2012 and 2022. All had locally advanced cervical cancer, although none had tumors that had spread to other organs.
The control group received only chemoradiotherapy, a standard process that included treatment with radiation and the drug cisplatin. The experimental group received six weeks of treatment with carboplatin and paclitaxel chemotherapy before beginning chemoradiotherapy.
The researchers found that 80% of those who got a short course of chemotherapy first lived at least five more years, and 72% did not have any cancer return or spread. In the control group, 72% survived at least five years, and 64% had no cancer return or spread.
Most patients had some kind of adverse event during treatment, including fatigue or weakness, gastrointestinal problems, infections or low white blood cell counts. Severe or life-threatening events happened in 59% of the group that got initial chemotherapy, compared with 48% of those who got chemoradiotherapy alone.
The researchers say theirs is the first randomized phase three study to show a 鈥渟ignificant survival advantage鈥� using chemotherapy before chemoradiotherapy, representing a 鈥渃linically meaningful improvement鈥� at a 鈥渞elatively low cost.鈥� The drugs are cheap and widely available, they say.
鈥淭his is the biggest improvement in outcome in this disease in over 20 years,鈥� Dr. Mary McCormack of University College Hospital, lead author of the study, said in . 鈥淚鈥檓 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.鈥�
Cisplatin-based chemotherapy is one of the most commonly used methods of treating cervical cancer, . While tumor removal surgery is an option, some experts tend to prefer chemotherapy.
鈥淲e know that surgery is going to leave some of the cancer behind,鈥� said Dr. Otis Brawley, a professor of oncology at Johns Hopkins University and former chief medical officer of the American Cancer Society, who was not involved with the new research. 鈥淚f you can treat with radiation and chemotherapy, you have a chance that you鈥檙e going to sterilize the pelvis of all of the cancer. 鈥� We have the chances that we鈥檙e going to put women into a prolonged, complete remission.鈥�
Cervical cancer was once the leading cause of cancer death for women in the United States, he noted. In 2008, , a German virologist, won the Nobel Prize for his research demonstrating that cervical cancer in humans is caused by certain types of human papillomavirus, or HPV. This discovery led to the development of an HPV vaccine that can help prevent cervical cancer in women.
However, still kills about . each year. Warning signs include abnormal bleeding or discharge.
Brawley stressed the importance of routine cervical screening as advanced-stage cervical cancer rises among White and Black women in the U.S.
According to the U.S. , cervical cancer screenings typically test for signs of HPV that can cause cell changes on the cervix. The screenings also include a Pap test to look for precancer cell changes.
The U.S. Food and Drug Administration greenlit a new option this year for patients to collect their own vaginal samples to test for HPV, streamlining the screening process.
鈥淚t鈥檚 almost totally preventable with either the HPV vaccine or screening,鈥� Brawley said. 鈥淥f the 4,400 deaths from cervical cancer, none of them get screened every year.鈥�
Chemotherapy to treat cervical cancer can come with unpleasant side effects like nausea, vomiting and hair loss, Brawley noted. He hopes the future of treatment will involve more personalized options like immunotherapy, which uses a person鈥檚 own immune system to fight cancer.
鈥淭he greatest hope is immunotherapy,鈥� he said. 鈥淲e鈥檙e hoping we can actually help even more women with less side effects.鈥�