Lu H, et al. - Researchers determined whether neoadjuvant chemoradiotherapy plus anti-epidermal growth factor receptor monoclonal antibody followed by surgery represents an efficacious and safe treatment option for patients with locally advanced cervical cancer (LACC). Based on the findings, concurrent chemoradiotherapy plus nimotuzumab followed by surgery was proved to be highly efficacious and safe in LACC.

Methods

• Patients with histologically proven LACC were recruited for this study.
• All patients were given intensity-modulated radiation therapy with conventional fractionation.
• They administered weekly cisplatin or nedaplatin concurrently with intensity-modulated radiation therapy.
• At a dose of 200 mg per week for 6 cycles, they administered nimotuzumab, a humanized anti-epidermal growth factor receptor monoclonal antibody.
• They assessed patients for clinical tumor response and operability based on MRI and gynecological examination about 1 month after the completion of neoadjuvant treatment.
• They performed radical hysterectomy and pelvic lymph node dissection 5-6 weeks after the completion of neoadjuvant therapy on those considered to be candidates for surgery.

Results

• They enrolled 28 patients, and clinical complete response and partial response was seen in 8 (28.5%) and 20 (71.5%) patients, respectively.
• Data showed that four patients were not eligible for surgery, and two patients refused surgery, although they were evaluated as surgical candidates; this analysis did not include them.
• For the remaining 22 patients, radical hysterectomy and pelvic lymph node dissection were performed.
• Based on pathological assessment, researchers found that eight (36.4%) had complete pathology response, nine (40.9%) presented with persistent atypical cells or cervical intraepithelial neoplasia, and five (22.7%) presented with macroscopic and/or microscopic residual disease.
• Median follow-up was 22 months (range: 5-39 months).
• The estimated 2-year locoregional control rate, progression-free survival rate, distant metastasis-free survival rate, and overall survival rate were 95.0%, 85.2%, 84.0%, and 90.0%, respectively.
• Data revealed that acute toxicities were mild in general and easily manageable.
• They found chronic toxicities were mainly limited to grade 1.
• They saw no severe late toxicities.