{"entity":{"id":"outback","kind":"trial","name":"OUTBACK / ANZGOG 0902 / GOG-0274","aka":[],"tldr":"Giving extra chemotherapy after chemoradiation added side effects and no survival benefit, so timing matters: chemotherapy helps before radiation (INTERLACE), not after.","summary":"OUTBACK, also ANZGOG 0902 and GOG-0274, trial NCT01414608 sponsored by ANZGOG and NRG Oncology and published in Lancet Oncology in 2023, showed that giving four cycles of carboplatin and paclitaxel after chemoradiation for locally advanced cervical cancer adds side effects and no survival benefit. It randomised 919 patients, found no difference in overall or progression-free survival at five years, and 22 percent of the adjuvant arm never received the planned chemotherapy while severe toxicity rose sharply. OnCo links it to cervical cancer, modern radiotherapy, carboplatin, paclitaxel, NRG Oncology, the GOG Foundation, Linda Mileshkin and the pairing of induction chemotherapy before chemoradiation. Set beside INTERLACE, it shows that timing matters: chemotherapy helps before radiation, not after, and why that should be so is the open question.","status":"negative","asOf":"2026-09-07","links":[{"label":"ClinicalTrials.gov NCT01414608","url":"https://clinicaltrials.gov/study/NCT01414608"},{"label":"Lancet Oncology 2023","url":"https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(23)00147-X/fulltext"}],"tags":["failure","lesson:timing"],"related":[],"cancers":["cervical","locally-advanced-cervical-cancer"],"sections":[],"technologies":["imrt-igrt"],"targets":[],"drugs":["carboplatin","paclitaxel"],"companies":["nrg-oncology","gog-foundation"],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":["linda-mileshkin"],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"nct":"NCT01414608","phase":"3","setting":"Locally advanced cervical cancer: chemoradiation followed by 4 cycles adjuvant carboplatin-paclitaxel vs chemoradiation alone","sponsor":"ANZGOG / NRG Oncology","result":"5-year OS 72% vs 71%; no benefit.","started":"2012-01-09","startedType":"actual","yearReported":2021,"enrolled":926,"enrolledBasis":"registry","outcomes":[{"endpoint":"Overall survival at 5 years","primary":true,"unit":"%","arms":[{"name":"CRT + adjuvant chemo","n":463,"value":72},{"name":"CRT alone","n":456,"value":71}],"hr":0.91,"ci":[0.7,1.18],"source":"https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(23)00147-X/fulltext"}]},"route":"/trials/outback/","neighbours":{"cancer":[{"id":"cervical","kind":"cancer","name":"Cervical cancer","route":"/cancers/cervical/"},{"id":"locally-advanced-cervical-cancer","kind":"cancer","name":"Locally advanced cervical cancer","route":"/cancers/locally-advanced-cervical-cancer/"}],"technology":[{"id":"imrt-igrt","kind":"technology","name":"IMRT / IGRT (modern external beam)","route":"/technologies/imrt-igrt/"}],"drug":[{"id":"carboplatin","kind":"drug","name":"Carboplatin","route":"/drugs/carboplatin/"},{"id":"paclitaxel","kind":"drug","name":"Paclitaxel / nab-paclitaxel","route":"/drugs/paclitaxel/"}],"company":[{"id":"gog-foundation","kind":"company","name":"GOG Foundation","route":"/companies/gog-foundation/"},{"id":"nrg-oncology","kind":"company","name":"NRG Oncology","route":"/companies/nrg-oncology/"}],"person":[{"id":"linda-mileshkin","kind":"person","name":"Linda Mileshkin","route":"/people/linda-mileshkin/"}],"pairing":[{"id":"induction-chemo-then-crt","kind":"pairing","name":"Induction chemotherapy → chemoradiation (locally advanced cervical cancer)","route":"/pairings/induction-chemo-then-crt/"}],"paper":[{"id":"paper-outback-lancet-oncol-2023","kind":"paper","name":"OUTBACK: adjuvant carboplatin-paclitaxel after chemoradiotherapy for locally advanced cervical cancer","route":"/key-papers/paper-outback-lancet-oncol-2023/"}]}}