New Cervical Cancer Treatment Approach Offers Hope for Longer Survival

A new approach to treating cervical cancer could help people with locally advanced cervical cancer live longer. This includes cancers that have spread beyond the cervix, but have not yet spread to distant parts of the body. The treatment approach involves giving chemotherapy (chemo) before chemoradiation. It was studied as part of the INTERLACE clinical trial.

“The most important take-home information from the INTERLACE trial is that in some people with cervical cancer that are considered at higher risk for recurrence, starting treatment with chemotherapy and then giving chemoradiation can help them live longer,” said Lan Coffman, MD, PhD, an American Society of Clinical Oncology (ASCO) expert and associate professor of hematology-oncology at the University of Pittsburgh School of Medicine. “These patients should talk to their doctor about considering giving chemotherapy first.”

What is chemoradiation?

Chemoradiation combines two treatments, chemotherapy and radiation therapy, to treat cancer. It's the standard treatment for many people with locally advanced cervical cancer. However, cervical cancer often comes back after chemoradiation and some people later die from the cancer.

Researchers designed the INTERLACE trial to learn whether giving chemo before chemoradiation could help people live longer.

Promising results from the INTERLACE trial

The INTERLACE trial was a phase III clinical trial. It compared the outcomes of standard chemoradiation to a regimen that starts with chemotherapy. It included 500 participants with locally advanced cervical cancer who were randomly assigned to one of two groups:

• Group 1 received chemotherapy (using the drugs carboplatin and paclitaxel) first, followed by chemoradiation (using the drug cisplatin along with radiation)
• Group 2 received standard chemoradiation (using cisplatin along with radiation), without the initial chemotherapy.

Key findings included:

• Higher survival rates: 5 years after treatment, 80% of those who recieved chemotherapy followed by chemoradiation were still living, compared to 72% of those who received chemoradiation alone.
• Slower cancer growth: The study also found that giving chemo first helped stop the cancer from growing in more patients. Of these patients, 72% had their cancer stop growing for 5 years after treatment, compared to 64% of those who received chemoradiation alone.

The results of the INTERLACE trial were recently published in The Lancet.

Weighing the benefits and challenges

While this new approach shows promise, it might not be the right approach for everyone. People who received chemo first reported more side effects. And Dr. Coffman noted that the new treatment with chemo first can add about 6 weeks to the treatment timeline.

When considering treatment, talk to your doctor about how it could impact your family, work, and quality of life.

Questions to ask your doctor

If you have cervical cancer, talk with your doctor about your possible treatment options. They can guide you on which specific treatment plan they recommend so you can make an informed decision together.

Some questions to ask your doctor include:

• What treatment do you recommend?
• Could getting chemo first be an option for me?
• What side effects can I expect?
• Can side effects be worse with one treatment than with others?

Dr. Coffman is an Associate Editor on ASCO’s Patient Information Editorial Board.