High-risk endometrial cancer: adjuvant chemoradiotherapy extends survival

  • de Boer SM
  • Lancet Oncol
  • 22 Jul 2019

  • curated by Deepa Koli
  • Univadis Clinical Summaries
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Takeaway

  • In patients with high-risk endometrial cancer (HREC), chemoradiotherapy (CRT; adjuvant chemotherapy during and after radiotherapy) extends OS and failure-free survival (FFS) vs pelvic radiotherapy alone.
  • Survival benefit was significant in patients with stage III or serous cancers.

Why this matters

  • CRT can become a new standard of care, especially for women with stage III endometrial cancer or serous cancers, or both.

Study design

  • Post hoc analysis of phase 3 PORTEC-3 trial of 660 women with HREC, randomly assigned to receive radiotherapy or CRT (2 cycles of cisplatin during RT, followed by 4 cycles of carboplatin-paclitaxel).
  • Funding: Dutch Cancer Society.

Key results

  • Median follow-up, 72.6 months.
  • At 5 years, CRT vs radiotherapy alone significantly improved:
    • OS (81.4% vs 76.1%; aHR, 0.70; P=.034);
    • FFS (76.5% vs 69.1%; aHR, 0.70; P=.016).
  • CRT significantly improved survival in:
    • stage III cancer: OS (aHR, 0.63; P=.043) and FFS (aHR, 0.61; P=.011);
    • serous cancer: OS (aHR, 0.48; P=.037) and FFS (aHR, 0.42; P=.008).
  • Distant metastases were more frequent with radiotherapy (HR, 0.74; P=.047).
  • Grade ≥3 adverse event (AE) rates were similar between groups.
  • Grade ≥2 AEs were more common in the CRT group (38% vs 23%; P=.002).
  • Grade ≥2 sensory neuropathy was more frequent with CRT (6% vs 0%).

Limitations

  • Open-label design.

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