Doctors are hailing a “remarkable” new treatment regimen for cervical cancer that cuts the risk of dying by 40%, in the biggest advance against the disease in 25 years.
Cervical cancer is the fourth most common cancer in women worldwide, with approximately 660,000 new cases and 350,000 deaths each year, according to the World Health Organization. In the UKthere are approximately 3,200 cases and 800 deaths each year.
Many of those affected are in their 30s, and despite improvements in care, the cancer returns in as many as 30% of cases.
The new treatment plan was tested in patients recruited over 10 years from the United Kingdom, Mexico, India, Italy and Brazil. It involves a short course of chemotherapy before patients undergo chemoradiation, the standard treatment for cervical cancer which involves a combination of chemotherapy and radiotherapy.
In research led by University College London, it was reported that the results of the phase-three clinical trial showed a 40% reduction in the risk of death from the disease and a 35% reduction in the risk of cancer occurring within least come back five years. Their findings were published in the Lancet.
Dr Mary McCormack, the lead investigator of the trial at UCL, told the Guardian that the discovery was the most important breakthrough in the treatment of cervical cancer since the end of the last century. “This is the biggest gain in survival since the adoption of chemoradiation in 1999,” she said.
“Any improvement in survival for a cancer patient is important, especially when the treatment is well tolerated and given for a relatively short time, allowing women to return to their normal lives relatively quickly.”
Researchers at UCL and University College London Hospital (UCLH) completed a long-term follow-up of patients who were given the short course of chemotherapy before chemoradiation.
The Interlace trial, funded by Cancer Research UK and UCL Cancer Trials Centre, looked at whether a short course of induction chemotherapy before chemoradiation could reduce relapses and deaths in patients with locally advanced cervical cancer that has not spread to other organs.
The trial recruited 500 women who were randomly assigned to receive either the new treatment regimen or the standard chemoradiation treatment. None of the patients’ tumors had spread to other organs.
In the study, one group received the new six-week regimen of carboplatin and paclitaxel chemotherapy. This was followed by standard radiotherapy plus weekly cisplatin and brachytherapy chemotherapy, known as chemoradiation. The control group received only the usual chemoradiation.
After five years, 80% of those who first received a short course of chemotherapy were alive and for 72% their cancer had not returned or spread. In the standard treatment group, 72% were alive and 64% did not have their cancer return or spread.
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Separately, UCL said the trial found a 40% reduction in the risk of death and a 35% reduction in the risk of cancer returning, when the two groups were compared by another measure.
Abbie Halls, a customer service manager from London who was diagnosed with cervical cancer when she was 27, is one of the women to receive the new treatment regimen. “I’ve been cancer-free for over nine years now and I’m not sure I’d be here without the treatment I received,” said the 37-year-old. “I am pleased to have been able to play a role in advancing the research, which I hope will save the lives of many more women in the years to come.”
The results called for the regime to be implemented across the UK and internationally. McCormack said: “A short course of induction chemotherapy before standard chemoradiation treatment significantly increases overall survival and reduces the risk of relapse in patients with locally advanced cervical cancer.
“This approach is a simple way to make a positive difference using existing drugs that are inexpensive and already approved for use in patients. It has already been adopted by some cancer centers and there is no reason why it should not be offered to all patients undergoing chemoradiation for this cancer.”
Dr Iain Foulkes, the executive director of research and innovation at Cancer Research UK, said: “The simple act of adding induction chemotherapy to the start of chemoradiation treatment for cervical cancer has produced remarkable results. A growing body of evidence shows that adding chemotherapy before other treatments, such as surgery and radiotherapy, can improve the chances of successful treatment for patients. Not only can it reduce the chances of cancer coming back, it can also be delivered quickly using drugs that are already available worldwide.”
