Loading
Six weekly cycles of carboplatin and paclitaxel given immediately before standard chemoradiation improved survival in locally advanced cervical cancer by about eight percentage points at five years, using cheap widely available drugs.
Phase 3 trial of 500 women with locally advanced cervical cancer (stage IB1 node-positive to IVA) randomised to six weeks of induction carboplatin-paclitaxel followed by cisplatin chemoradiotherapy, or chemoradiotherapy alone.
Five-year progression-free survival was 72 versus 64 percent (hazard ratio 0.65) and overall survival 80 versus 72 percent (hazard ratio 0.60), with more haematological toxicity during induction but no compromise of chemoradiation delivery.
Short induction chemotherapy is a standard option before chemoradiation, particularly where pembrolizumab is unaffordable, and can be delivered in most health systems.