Amol Akhade: Exciting advancements in cervical cancer treatment with two major breakthroughs over this year

Amol Akhade shared a post on LinkedIn:

”Exciting advancements in cervical cancer treatment with two major breakthroughs over this year!

Recent Phase 3 Randomized Controlled Trials, Interlace and Keynote A18, have shown overall survival benefits in cervical cancer patients.

The Interlace trial, utilizing neoadjuvant chemotherapy followed by concurrent chemo-radiation, demonstrated a 5-year overall survival benefit of 8% with a hazard ratio of 0.60.

On the other hand, the Keynote A18 trial, involving pembrolizumab treatment, concurrent 5 cycles and maintenance 12 cycles showed, a 3-year overall survival benefit of 8% and a hazard ratio of 0.67.

Despite their successes, both trials face challenges.

Interlace’s dose and technique for radiotherapy raised questions among experts.

The use of pembrolizumab in Keynote A18, already approved for metastatic cancer, raised concerns about patient response on progression and financial toxicity due to the 17 doses.

A recent survey among oncologists revealed preferences for treatment approaches, with 46% favoring Interlace, 26% supporting Keynote A18, 19% opting for a combination, and 10% preferring only chemoradiation.

This preference reflects concerns about costs, particularly in resource-constrained settings, indicating a leaning towards the Interlace approach.

In conclusion, Keynote A18 may be preferred for advanced stages with high nodal burden, while Interlace could be the go-to for earlier stages with less disease volume. These findings shed light on the importance of considering cost implications in treatment decisions, especially in resource-limited settings.”

Amol Akhade is a senior consultant medical oncologist and hemato-oncologist. He has received his super specialization training in hemato-oncology and medical oncology from Tata Memorial Hospital. He specialises in chemotherapy for hematological cancers as well as solid tumors. He also specialises in allogenic and autologous bone marrow transplant. Currently, he is a Consultant Medical Oncologist at Suyog Cancer Clinics and Reliance Hospitals.