Cervical cancer: chemoradiation with doublet tops monotherapy in meta-analysis

  • Ma S & al.
  • Gynecol Oncol
  • 18 Apr 2019

  • curated by Deepa Koli
  • Univadis Clinical Summaries
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Takeaway

  • Meta-analysis suggests platinum-based doublet therapy plus radiotherapy (RT) significantly prolongs survival in patients with locally advanced cervical cancer vs RT plus single-agent chemotherapy.
  • Platinum-based doublet therapy group was associated with higher risk for toxicities.

Why this matters

  • Concurrent chemoradiation is still the first-line treatment for locally advanced cervical cancer, but there is no standard chemotherapy regimen.
  • Platinum-based doublet therapy should be considered in patients who are able to tolerate it.

Study design

  • Meta-analysis of 7 randomized controlled trials including 1503 patients with locally advanced cervical cancer undergoing radiotherapy (RT) with concurrent platinum-based doublet or cisplatin monotherapy.
  • Outcomes: OS, PFS, and safety.
  • Funding: None.

Key results

  • Concurrent RT with platinum-based doublet chemotherapy significantly improved OS and PFS vs RT with cisplatin monotherapy:
    • OS: 7 studies; HR, 0.75 (P=.01).
    • PFS: 7 studies; HR, 0.78 (P=.01).
  • RT+doublet chemotherapy group showed higher risk for:
    • vomiting (related ratio [RR], 3.19; P<.0001>
    • thrombocytopenia (RR, 2.75; P=.004), and
    • urinary system toxicity (RR, 4.58; P=.05).

Limitations

  • Only 2 phase 3 trials included.

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