INTERLACE: induction chemotherapy before chemoradiotherapy for locally advanced cervical cancer
Six weekly cycles of carboplatin and paclitaxel given immediately before standard chemoradiation improved survival in locally advanced cervical cancer by about eight percentage points at five years, using cheap widely available drugs.
Overview
Phase 3 trial of 500 women with locally advanced cervical cancer (stage IB1 node-positive to IVA) randomised to six weeks of induction carboplatin-paclitaxel followed by cisplatin chemoradiotherapy, or chemoradiotherapy alone.
Five-year progression-free survival was 72 versus 64 percent (hazard ratio 0.65) and overall survival 80 versus 72 percent (hazard ratio 0.60), with more haematological toxicity during induction but no compromise of chemoradiation delivery.
- Five-year progression-free survival 72 percent vs 64 percent; hazard ratio 0.65.
- Five-year overall survival 80 percent vs 72 percent; hazard ratio 0.60.
Short induction chemotherapy is a standard option before chemoradiation, particularly where pembrolizumab is unaffordable, and can be delivered in most health systems.
- Most patients had stage IIB disease; fewer node-positive and stage III patients.
- Whether induction adds to chemoradiation plus pembrolizumab is untested.