title: Neoadjuvant chemotherapy in cervical cancer: an update.
abstract: The role of neoadjuvant chemotherapy (NACT) has been investigated in order to improve prognosis of patients with locally advanced cervical cancer. According to a meta-analysis, NACT followed by radiotherapy may be detrimental with a low dose of cisplatin and longer cycle intervals. Some meta-analyses showed NACT followed by surgery resulted in a reduction in the risk of death by 35% with a gain of 14% in the 5-year survival compared with radiotherapy. In a Cochrane meta-analysis, overall survival and progression-free survival were significantly improved with NACT followed by surgery versus surgery alone (23% reduction in the risk of death). The platinum/paclitaxel combination is now the preferred regimen in the neoadjuvant setting and preliminary data indicate that dose-dense regimens are feasible and effective (overall response rate: 67.8-87%). A weekly regimen with carboplatin/paclitaxel before chemoradiation showed promising results and the INTERLACE ongoing trial will help to confirm whether additional short-course chemotherapy given weekly before chemoradiation will lead to an improvement in overall survival.
authors.affiliation: a 1 European Institute of Oncology, Division of Medical Gynecologic Oncology, via Giuseppe Ripamonti 435, 20141 Milan, Italy.
authors.forename: Mariateresa
authors.initials: M
authors.lastname: Lapresa
authors.affiliation: a 1 European Institute of Oncology, Division of Medical Gynecologic Oncology, via Giuseppe Ripamonti 435, 20141 Milan, Italy.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Parma
authors.affiliation: b 2 Department of Gynaecology and Obstetrics, University Campus Bio Medico, Rome, Italy.
authors.forename: Rosalba
authors.initials: R
authors.lastname: Portuesi
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Colombo
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D020360:Neoadjuvant Therapy / Q000379:methods; D011379:Prognosis; D015996:Survival Rate; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000628:therapy*
keywords: emerging therapies; locally advanced cervical cancer; neoadjuvant chemotherapy; radiotherapy; surgery