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
