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Induction Chemotherapy Plus Chemoradiation as First Line Treatment for Locally Advanced Cervical Cancer
Sponsor: University College, London
Summary
Chemoradiation has been the standard treatment for advanced cervical cancer for a decade, but one third of women still die from a failure to control systemic disease. In a recent multicentre phase II trial of 46 women the investigators found that, 68% of women had tumours that responded to weekly induction chemotherapy prior to chemoradiation. The induction chemotherapy had acceptable toxicity and did not compromise the standard chemoradiation treatment. In addition, the overall survival and progression free survival at 3 years was 66% (95% CI 4779). These results, together with acceptable toxicity, provide justification for evaluating induction chemotherapy prior to chemoradiation in a randomised phase III trial. The investigators aim to investigate in a randomised trial whether additional induction chemotherapy given on a weekly schedule immediately before standard chemoradiation leads to an improvement in overall survival. The investigators plan to recruit 770 women with locally advanced cervical cancer who are eligible for standard chemoradiation, they will be randomised to weekly carboplatin and paclitaxel chemotherapy for 6 weeks followed by chemoradiation or to chemoradiation alone. The trial will recruit for 4 years with 5 years of follow up period.
Official title: A Phase III Multicentre Trial of Weekly Induction Chemotherapy Followed by Standard Chemoradiation Versus Standard Chemoradiation Alone in Patients With Locally Advanced Cervical Cancer
Key Details
Gender
FEMALE
Age Range
18 Years - Any
Study Type
INTERVENTIONAL
Enrollment
500
Start Date
2012-11-08
Completion Date
2026-12
Last Updated
2024-12-05
Healthy Volunteers
No
Conditions
Interventions
Paclitaxel
Paclitaxel 80 mg/m2 (capped at 162mg maximum total dose) weekly for 6 weeks i.e. on days 1, 8, 15, 22, 29 \& 36.
Carboplatin
Carboplatin AUC 2 (capped at 270mg maximum total dose) weekly for 6 weeks i.e. on day 1, 8, 15, 22, 29, \& 36.
Radiotherapy
Radiotherapy comprising external beam 40-50.4Gy in 20-28 fractions plus intracavity brachytherapy to achieve a minimum total EQD2 dose of 78-86Gy.
Cisplatin
Cisplatin 40 mg/m2 (capped at 70mg total dose) weekly for five weeks maximum, commencing in the first week of radiotherapy or as soon as blood counts have recovered from induction chemotherapy.
Locations (35)
Instituto do Câncer do Estado de São Paulo
São Paulo, Brazil
Chittaranjan National Cancer Institute (CNCI)
Kolkata, India
Saroj Gupta Cancer Centre and Research Institute
Kolkata, India
Istituto Europeo di Oncologia
Milan, Lombardy, Italy
Instituto Nacional de Cancerologia (INCAN)
Mexico City, Mexico
North Devon District Hospital
Barnstaple, Devon, United Kingdom
University College London Hospital
London, Greater London, United Kingdom
Weston Park Hospital
Sheffield, South Yorkshire, United Kingdom
Belfast City Hospital
Belfast, United Kingdom
Pilgrim Hospital
Boston, United Kingdom
Royal Sussex County Hospital
Brighton, United Kingdom
Velindre Cancer Centre
Cardiff, United Kingdom
Cheltenham General Hospital
Cheltenham, United Kingdom
Royal Derby Hospital
Derby, United Kingdom
Royal Devon and Exeter NHS Foundation Trust
Exeter, United Kingdom
Beatson WOSCC
Glasgow, United Kingdom
Gloucester Royal Hospital
Gloucester, United Kingdom
Grantham and District Hospital
Grantham, United Kingdom
Castle Hill Hospital
Hull, United Kingdom
Leicester Royal Infirmary
Leicester, United Kingdom
Lincoln County Hospital
Lincoln, United Kingdom
Guy's and St Thomas' NHS Foundation Trust
London, United Kingdom
Imperial College Healthcare NHS Trust
London, United Kingdom
St Bart's Hospital
London, United Kingdom
The Christie NHS Foundation Trust
Manchester, United Kingdom
The Clatterbridge Cancer Centre
Metropolitan Borough of Wirral, United Kingdom
James Cook University Hospital
Middlesbrough, United Kingdom
Northampton General Hospital
Northampton, United Kingdom
Norfolk and Norwich University Hospital
Norwich, United Kingdom
Nottingham University Hospitals NHS Trust
Nottingham, United Kingdom
Derriford Hospital
Plymouth, United Kingdom
Southampton General Hospital
Southampton, United Kingdom
Royal Stoke University Hospital
Stoke-on-Trent, United Kingdom
Royal Cornwall Hospital
Truro, United Kingdom
New Cross Hospital
Wolverhampton, United Kingdom