- A new study shows that changing when some people receive chemotherapy may reduce the risk of death and reoccurrence of cervical cancer.
- There are about 13,960 new cases of invasive cervical cancer in the U.S. every year.
- Delivering chemotherapy immediately before the standard chemoradiation treatment may cut the risk of death or cancer recurrence by 35%, the study found.
New research found that administering chemotherapy before the standard chemoradiation treatment (CRT) can improve survival rates and prevent cancer recurrence in people diagnosed with cervical cancer.
According to the study recently published in the Annals of Oncology, an initial six-week course of chemotherapy can reduce the risk of death or cancer recurrence by 35%.
Induction chemotherapy, where some chemotherapy is given before the definitive treatment, is commonly given before surgery for ovarian and uterine cancer, according to Dr. Elena Ratner, the co-chief of the section of gynecologic oncology at Yale Cancer Center.
Though it’s less routinely utilized with cervical cancer, this type of chemotherapy may help eliminate microscopic disease or smaller lesions that would not be removed with CRT alone.
“There’s a lot of thought that this kind of induction therapy is very beneficial in reducing rates of recurrences,” Ratner, who was not involved with the study, said.
The researchers recruited 500 patients who had been diagnosed with cervical cancer that was large enough to be seen without a microscope but hadn’t spread to other parts of the body.
The patients were split into two groups: one that received standard CRT and another that had an initial six-week course of chemotherapy before receiving standard CRT.
After five years, 80% of the patients who had received the additional six-week course of chemotherapy were alive and 73% did not have their cancer return or spread.
In the group that only received standard CRT, 72% were alive and 64% didn’t have their cancer return or spread.
The findings show that delivering chemotherapy immediately before the standard CRT may cut the risk of death or cancer recurrence by 35%.
“The main takeaway from the study is that an additional six-week course of chemotherapy prior to chemotherapy and radiation helps improve outcomes and survival for patients with locally advanced cervical cancer,” said Dr. Amer Karam, a gynecologic surgeon at Stanford Health Care. Karam was not involved with the study.
There are likely multiple mechanisms that explain why the added round of chemotherapy improves survival, according to Dr. Oliver Dorigo, PhD, the director of the division of gynecologic oncology in the Department of Obstetrics and Gynecology at Stanford Medicine.
“Chemotherapy using carboplatin and paclitaxel might treat undetectable metastatic sites of disease beyond the pelvis,” said Dorigo, who was not involved with the study.
It’s possible that microscopic or minuscule cancer cells go undetected on PET or CT scans, and while surgery and radiation are effective, both treatments are localized, meaning they treat very specific areas of the body.
Chemotherapy, on the other hand, is systemic and can eliminate cancer cells locate outside of the surgery site or radiation field.
“It likely reduces and kills cancer cells outside of the field of radiation, which could grow and metastasize despite the chemoradiation,” said Karam.
It’s also possible that induction chemotherapy improves the efficacy of chemoradiation by decreasing the size of the tumor and increasing the sensitivity of the cancer cells to radiation, said Dorigo.
According to the researchers, the drugs used for induction chemotherapy — carboplatin and paclitaxel chemotherapy — are affordable, accessible, and already approved for use in cancer patients.
As a result, a six-week course of chemotherapy could be integrated into treatment of cervical cancer quickly.
The medications are also well-tolerated and effective across diverse patient populations, says Dorigo.
“This treatment should be considered the new standard of care for patients with locally-advanced cervical cancer,” said Dorigo.
With cancer, treatment is personalized per each patient.
In cases where it’s unclear if the cervical cancer is limited to the pelvis, for example, induction chemotherapy may be beneficial, said Ratner.
“I do think this study gives a lot of ammunition, background, and reasoning for the mechanism for using this in a personalized, individualized basis,” she said.
Cervical cancer occurs when cells within the cervix lining in the lower area of the uterus become cancerous.
There are about 13,960 new cases of invasive cervical cancer in the United States every year, according to the
A new study found that administering chemotherapy before chemoradiation can improve survival rates and prevent cancer recurrence in people diagnosed with cervical cancer.
An initial six-week course of chemotherapy can cut the risk of death or cancer recurrence by 35%, according to the report.
Because chemotherapy is affordable and accessible, an added round of chemotherapy could be integrated into the treatment of cervical cancer quickly, the researchers say.