CC BY-NC-ND 4.0 · Geburtshilfe Frauenheilkd 2024; 84(06): 523-528
DOI: 10.1055/a-2279-3163
GebFra Science
Statement/Stellungnahme

Statement of the Uterus Commission of the Gynecological Oncology Working Group (AGO) on Neoadjuvant Chemotherapy Prior to Definitive Radiochemotherapy in Patients with Locally Advanced Cervical Cancer

Article in several languages: English | deutsch
Clemens Tempfer
1   Universitätsfrauenklinik, Comprehensive Cancer Center der Ruhr Universität Bochum (RUCCC), Bochum, Germany
,
Tanja Fehm
2   Universitätsfrauenklinik der Universität Düsseldorf, CIO ABCD, Düsseldorf, Germany
,
Dirk Vordermark
3   Universitätsklinik und Poliklinik für Strahlentherapie der Martin-Luther-Universität Halle-Wittenberg, Halle-Wittenberg, Germany
,
Simone Marnitz-Schulze
4   RadioOnkologie im Vosspalais, Berlin, Germany
,
Matthias W. Beckmann
5   Frauenklinik, Comprehensive Cancer Center ER-EMN, Universitätsklinikum Erlangen, Erlangen, Germany
,
Dominik Denschlag
6   Frauenklinik, Hochtaunus Kliniken Bad Homburg, Bad Homburg, Germany
,
Sara Brucker
7   Universitätsfrauenklinik Tübingen, Department für Frauengesundheit, Tübingen, Germany
,
Markus Wallwiener
8   Universitätsklinik und Poliklinik für Gynäkologie der Martin-Luther-Universität Halle-Wittenberg, Halle-Wittenberg, Germany
,
Michael Eichbaum
9   Klinik für Frauenheilkunde und Geburtshilfe, Helios HSK Wiesbaden, Wiesbaden, Germany
,
Beyhan Ataseven
10   Universitätsklinik für Frauenheilkunde und Geburtshilfe der Universität Bielefeld UK OWL, Klinikum Lippe, Bielefeld, Germany
,
Peter Hillemanns
11   Frauenklinik, Comprehensive Cancer Center Niedersachsen, Medizinische Hochschule Hannover, Hannover, Germany
,
für die Kommission Uterus der AGO › Author Affiliations
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Abstract

The presentation of the results of the prospective randomized international multicenter GCIG INTERLACE trial at the 2023 congress of the European Society of Medical Oncology (ESMO) is likely to change the therapy for locally advanced cervical cancer. In the GCIG INTERLACE trial, six cycles of neoadjuvant chemotherapy administered weekly and consisting of carboplatin AUC2 and paclitaxel 80 mg/m2 followed by definitive radiochemotherapy with pelvic radiotherapy (40 – 50.4 Gray) and cisplatin (40 mg/m2 once a week for 5 weeks) and brachytherapy (total dose EQD2 at least 78 Gy at point A) (experimental arm) were compared with definitive radiochemotherapy alone (standard arm) in patients with locally advanced cervical cancer (Fédération Internationale de Gynécologie et dʼObstétrique [FIGO] 2008 stage IB1/node positive, IB2, II, IIIB and IVA) and was found to be significantly superior with significantly longer recurrence-free survival (hazard ratio [HR] 0.65; 95% confidence interval [CI] 0.64 – 0.91; p = 0.013) and significantly longer overall survival rates (HR 0.61; 95% CI: 0.40 – 0.91; p = 0.04) after 5 yearsʼ follow-up. After considering the results of the GCIG INTERLACE trial published at the congress, the Uterus Commission of the AGO is of the opinion that neoadjuvant chemotherapy with carboplatin AUC2 and paclitaxel 80 mg/m2 d1, q7, x6 may be offered to patients with locally advanced cervical cancer (FIGO stage IB1/node positive, IB2, II, IIIB and IVA) in addition to the current standard therapy after the patient has been informed about the risks, with the decision taken on a case-by-case basis. However, before this approach can be discussed at guideline level or defined as the new therapy standard, it will be necessary to wait until the data from the full publication are available.

Keywords

cervical cancer - radical hysterectomy - locally advanced disease - neoadjuvant chemotherapy


Publication History

Received: 26 February 2024

Accepted: 26 February 2024

Article published online:
15 April 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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