Primoz Petric: INTERLACE – Not a New Standard for Cervical Cancer Chemoradiation
Primoz Petric, Chief Physician at Lucerne Cantonal Hospital, shared a post on LinkedIn:
“INTERLACE: Not a New Standard.
Before recommending the INTERLACE Induction Chemotherapy for cervical cancer, please consider our opinion, showing why this study warrants caution.
Main points:
-Apparent benefit of ICT was due to suboptimal radiotherapy in control arm, which is not considered standard treatment nowadays.
-Results of modern EMBRACE-type chemoradiation including image guided adaptive brachytherapy (IGABT) seem comparable or superior to the ICT arm of INTERLACE trisal
-High number needed to treat to prevent an isolated distant relapse: ICT was ineffective in >90% of unselected LACC patients.
-Higher acute toxicity of ICT than control arm hampered concomitant cisplatin delivery during radiotherapy and compromises delivery of high-quality iIGABT (personal experience).
-Real-world patients face greater risk of harm from ICT
-In settings with high patient-numbers, ICT is costly, and may divert resources from much-needed access to radiotherapy, especially in LMICs.
Bottom line: The reported effect of ICT may be merely a compensation of suboptimal radiotherapy. ICT is ineffective for most unselected patients, increases toxicity, complicates delivery of IGABT, adds cost, and risks undermining global cancer care priorities. Further studies are needed to indentify patients who might benefit from NACT.”
Title: INTERLACE: not a new standard for cervical cancer chemoradiation
Authors: Primoz Petric, Jacob Christian Lindegaard, Maximillian Paul Schmid, Ina Jürgenliemk-Schulz, Umesh Mahantshetty, Christian Kirisits, Richard Pötter
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