Neoadjuvant chemotherapy in locally advanced cervical cancer : real-world evidence data from the Cancer Medicines Outcomes Programme (CMOP)

Baillie, Kelly and Reed, Nicholas and Laskey, Jennifer and Pan, Jiafeng and Kavanagh, Kimberley and Bennie, Marion and Crearie, Christine and Mueller, Tanja and Sadozye, Azmat and Harrand, Rosie and Kerr, Ashleigh and Graham, Kathryn (2021) Neoadjuvant chemotherapy in locally advanced cervical cancer : real-world evidence data from the Cancer Medicines Outcomes Programme (CMOP). European Journal of Gynaecological Oncology, 42 (5). pp. 926-935. ISSN 0392-2936 (https://doi.org/10.31083/j.ejgo4205140)

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Abstract

Objective: To report the outcomes of neoadjuvant chemotherapy (NACT) in patients with locally advanced cervical cancer, we conducted a retrospective study of 126 patients. Methods: The electronic chemotherapy prescribing system was used to identify patients from the West of Scotland Cancer Network who received NACT over a 5 year period. Baseline characteristic and treatments details were collected. Association of treatment type and other variables with overall survival (OS) were analysed using Cox proportional hazards model. Results: The median follow up was 30 months. Median age was 44 years (interquartile range 34–54), 86% had squamous pathology and 93% had at least International Federation of Gynaecology & Obstetrics (FIGO) stage II disease at diagnosis. 27% had stage IV disease and 30% had para-aortic nodal involvement. NACT regimens consisted primarily of 3 weekly cisplatin/paclitaxel (63%) or carboplatin/paclitaxel (35%). 86% of patients subsequently received chemoradiotherapy (CCRT), 11% radical radiotherapy alone and the remaining patients progressed or defaulted. Three year OS was 61.8% (95% CI (Confidence Interval) 53.4–71.6). Survival was poorer in patients with neutrophil lymphocyte ratio (NLR) ≥ 5 (hazard ratio 2.8 (95% CI 1.32–5.90)) and in those not receiving CCRT (hazard ratio 2.23 (95% CI 1.01–4.91)). Conclusions: Three year OS was reasonable considering the advanced nature of the cohort and suggests that NACT is an option for women with bulky cervical cancer.

ORCID iDs

Baillie, Kelly, Reed, Nicholas, Laskey, Jennifer, Pan, Jiafeng ORCID logoORCID: https://orcid.org/0000-0001-5993-3209, Kavanagh, Kimberley ORCID logoORCID: https://orcid.org/0000-0002-2679-5409, Bennie, Marion ORCID logoORCID: https://orcid.org/0000-0002-4046-629X, Crearie, Christine, Mueller, Tanja ORCID logoORCID: https://orcid.org/0000-0002-0418-4789, Sadozye, Azmat, Harrand, Rosie, Kerr, Ashleigh and Graham, Kathryn;
CORE (COnnecting REpositories)