The latest cervical cancer treatment significantly reduces the likelihood of mortality due to the disease, as indicated by trial findings.
The research, released on Monday in The Lancet journal, involved 500 patients from 32 medical centers in Brazil, India, Italy, Mexico, and the UK. These patients, assigned randomly between 2012 and 2022, all had locally advanced cervical cancer without any metastasis to other organs.
The control group underwent only chemoradiotherapy, which involved radiation treatment and the medication cisplatin. The experimental group, on the other hand, received a six-week course of chemotherapy with carboplatin and paclitaxel before progressing to chemoradiotherapy.
The study found that 80% of patients in the initial chemotherapy group lived for at least five more years, with 72% experiencing no cancer recurrence or metastasis. In comparison, 72% of the chemoradiotherapy-only group survived for five years, and 64% experienced no cancer recurrence or metastasis.
Most patients experienced some form of adverse event during treatment, including fatigue, weakness, gastrointestinal issues, infections, or low white blood cell counts. More severe or potentially life-threatening events occurred in 59% of the initial chemotherapy group compared to 48% of the chemoradiotherapy-only group.
The researchers claim this is the first randomized phase three study to demonstrate a "significant survival advantage" through using chemotherapy before chemoradiotherapy, representing a "meaningful improvement" at a "relatively low cost." The drugs are affordable and widely accessible, they argue.
Dr. Mary McCormack of University College Hospital, the study's lead author, stated in an interview with Cancer Research UK that this improvement is the "biggest in outcome" for this disease in over 20 years.
Cisplatin-based chemotherapy is a widely used method for treating cervical cancer, enhancing survival rates by approximately 30% to 50%. Although tumor removal surgery is an option, some experts prefer chemotherapy due to the potential for better eradication of cancer.
Dr. Otis Brawley, a professor of oncology at Johns Hopkins University and former chief medical officer of the American Cancer Society, who was not involved in the research, asserted, "If you can treat with radiation and chemotherapy, you have a chance that you’re going to sterilize the pelvis of all of the cancer. ... We have the chances that we’re going to put women into a prolonged, complete remission."
Cervical cancer was once the leading cause of cancer-related deaths for women in the United States. In 2008, Harald zur Hausen, a German virologist, was awarded the Nobel Prize for his research proving that human papillomavirus (HPV) is responsible for the development of cervical cancer in humans. This discovery led to the creation of an HPV vaccine to help prevent cervical cancer in women.
Regardless, about 4,000 women in the US succumb to cervical cancer each year. Symptoms include abnormal bleeding or discharge.
Brawley emphasized the importance of regular cervical screenings, as the incidence of advanced-stage cervical cancer is rising among White and Black women in the US.
According to the US Centers for Disease Control and Prevention, cervical cancer screenings primarily check for HPV-induced cell changes on the cervix. These screenings also involve a Pap test to examine for precancer cell changes.
CNN Health's newsletter, "The Results Are In with Dr. Sanjay Gupta," offers weekly updates.
The US Food and Drug Administration approved a new self-collection option for vaginal samples to test for HPV this year, making the screening process more convenient.
Brawley emphasized that cervical cancer is nearly completely preventable through either the HPV vaccine or regular screenings, as only a small percentage of those who die from the disease undergo annual screenings.
Chemotherapy for cervical cancer can bring about side effects such as nausea, vomiting, and hair loss. Brawley hopes for future treatment options with fewer side effects, like immunotherapy, which utilizes a person's own immune system to combat cancer.
Brawley concluded, "The greatest hope is immunotherapy. We’re hoping we can actually help even more women with less side effects."
The study highlights a "significant survival advantage" for patients with locally advanced cervical cancer when they undergo chemotherapy before chemoradiotherapy, potentially improving their health outcomes. Regular cervical screenings are crucial in preventing advanced-stage cervical cancer, thereby maintaining overall health.
