Neoadjuvant chemotherapy in cervical cancer: an update

作者：Lapresa Mariateresa^*; Parma Gabriella; Portuesi Rosalba; Colombo Nicoletta

来源：Expert Review of Anticancer Therapy, 2015, 15(10): 1171-1181.

DOI：10.1586/14737140.2015.1079777

• emerging therapies
• locally advanced cervical cancer
• neoadjuvant chemotherapy
• radiotherapy
• surgery

The role of neoadjuvant chemotherapy (NACT) has been investigated in order to improve prognosis of patients with locally advanced cervical cancer. According to a meta-analysis, NACT followed by radiotherapy may be detrimental with a low dose of cisplatin and longer cycle intervals. Some meta-analyses showed NACT followed by surgery resulted in a reduction in the risk of death by 35% with a gain of 14% in the 5-year survival compared with radiotherapy. In a Cochrane meta-analysis, overall survival and progression-free survival were significantly improved with NACT followed by surgery versus surgery alone (23% reduction in the risk of death). The platinum/paclitaxel combination is now the preferred regimen in the neoadjuvant setting and preliminary data indicate that dose-dense regimens are feasible and effective (overall response rate: 67.8-87%). A weekly regimen with carboplatin/paclitaxel before chemoradiation showed promising results and the INTERLACE ongoing trial will help to confirm whether additional short-course chemotherapy given weekly before chemoradiation will lead to an improvement in overall survival.

• 出版日期2015