# Induction chemotherapy → chemoradiation (locally advanced cervical cancer)

Source: https://onco.cc/pairings/induction-chemo-then-crt/  
OnCo record `induction-chemo-then-crt` (Pairing). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Six weeks of cheap chemotherapy before chemoradiation cut deaths by 40% (INTERLACE), while chemotherapy after chemoradiation did nothing (OUTBACK). Order matters.

## Summary

Six weeks of carboplatin-based induction chemotherapy before definitive chemoradiation for locally advanced cervical cancer is a sequence pairing that improved survival in the phase 3 INTERLACE trial. By contrast, OUTBACK / ANZGOG 0902 / GOG-0274 gave adjuvant chemotherapy after chemoradiation and found no benefit but considerably more toxicity, so the order matters. The rationale is that induction achieves early systemic control of micrometastases while patients are still fit, whereas chemotherapy after radiation suffers from poor compliance and marrow toxicity. Because the induction drugs are cheap, the approach is deliverable in low- and middle-income countries where pembrolizumab is not, and it pairs with modern external beam radiotherapy and brachytherapy.

## Fields

- Kind: Pairing
- Last checked: 2026-09-07
- Pairs: Carboplatin + IMRT / IGRT (modern external beam)
- Type: sequence
- Rationale: Early systemic control of micrometastases while patients are fit; adjuvant chemotherapy after radiation suffers poor compliance and marrow toxicity.
- Evidence: One positive phase 3 (induction) and one negative phase 3 (adjuvant).

## Sources

- ClinicalTrials.gov NCT01566240: INTERLACE: https://clinicaltrials.gov/study/NCT01566240
- ClinicalTrials.gov NCT01414608: OUTBACK / ANZGOG 0902 / GOG-0274: https://clinicaltrials.gov/study/NCT01414608

## Connected records

- cancers: [Cervical cancer](https://onco.cc/cancers/cervical/), [Locally advanced cervical cancer](https://onco.cc/cancers/locally-advanced-cervical-cancer/)
- technologies: [Brachytherapy](https://onco.cc/technologies/brachytherapy/), [IMRT / IGRT (modern external beam)](https://onco.cc/technologies/imrt-igrt/)
- trials: [INTERLACE](https://onco.cc/trials/interlace/), [OUTBACK / ANZGOG 0902 / GOG-0274](https://onco.cc/trials/outback/)
- drugs: [Carboplatin](https://onco.cc/drugs/carboplatin/)

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