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Adding four cycles of carboplatin-paclitaxel chemotherapy after standard chemoradiation did not improve survival in locally advanced cervical cancer and caused more side effects, so adjuvant chemotherapy is not recommended.
Phase 3 trial of 919 women with locally advanced cervical cancer randomised to cisplatin chemoradiotherapy alone or followed by four cycles of adjuvant carboplatin and paclitaxel.
Five-year overall survival was 72 versus 71 percent and progression-free survival 63 versus 61 percent, with more grade 3 to 5 adverse events with adjuvant chemotherapy (81 versus 62 percent) and a fifth of patients never starting it.
Chemotherapy after chemoradiation adds toxicity without benefit; the search for improvement has moved to induction chemotherapy (INTERLACE) and immunotherapy (KEYNOTE-A18).
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