# OUTBACK: adjuvant carboplatin-paclitaxel after chemoradiotherapy for locally advanced cervical cancer

Source: https://onco.cc/key-papers/paper-outback-lancet-oncol-2023/  
OnCo record `paper-outback-lancet-oncol-2023` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Adding four cycles of carboplatin-paclitaxel chemotherapy after standard chemoradiation did not improve survival in locally advanced cervical cancer and caused more side effects, so adjuvant chemotherapy is not recommended.

## Summary

Phase 3 trial of 919 women with locally advanced cervical cancer randomised to cisplatin chemoradiotherapy alone or followed by four cycles of adjuvant carboplatin and paclitaxel.

Five-year overall survival was 72 versus 71 percent and progression-free survival 63 versus 61 percent, with more grade 3 to 5 adverse events with adjuvant chemotherapy (81 versus 62 percent) and a fifth of patients never starting it.

## Fields

- Kind: Key paper
- Last checked: 2026-09-17
- Journal: The Lancet Oncology
- Year: 2023
- DOI: 10.1016/S1470-2045(23)00147-X
- Authors: Mileshkin LR, Moore KN, Barnes EH, et al.
- Findings: Five-year overall survival 72 percent vs 71 percent.; Grade 3 to 5 adverse events 81 percent vs 62 percent.
- What it means: Chemotherapy after chemoradiation adds toxicity without benefit; the search for improvement has moved to induction chemotherapy (INTERLACE) and immunotherapy (KEYNOTE-A18).
- Caveats: Compliance with adjuvant chemotherapy was incomplete, which may have diluted any effect.

## Sources

- Lancet Oncol 2023: https://doi.org/10.1016/S1470-2045(23)00147-X
- PubMed: https://pubmed.ncbi.nlm.nih.gov/37080223/

## Connected records

- cancers: [Locally advanced cervical cancer](https://onco.cc/cancers/locally-advanced-cervical-cancer/)
- trials: [OUTBACK / ANZGOG 0902 / GOG-0274](https://onco.cc/trials/outback/)
- journals: [The Lancet Oncology](https://onco.cc/journals/lancet-oncology/)

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