Cetuximab plus chemoradiotherapy feasible in women with cervical carcinoma

Treatment with cetuximab plus cisplatin 30 mg/m² and radiotherapy appears safe and well tolerated in women with cervical carcinoma, a study has shown. In addition, fluorine-18 fluorodeoxyglucose-positron emission tomography/computed tomography (¹⁸F-FDG-PET/CT) has exhibited early evidence of response to neoadjuvant cetuximab.

Eligible patients with International Federation of Gynecology and Obstetrics (FIGO) stage IB-IVB invasive carcinoma of the uterine cervix underwent one of three dose levels (DL).

DL1 involved neoadjuvant cetuximab, followed by concurrent radiotherapy with cetuximab 250 mg/m²/cisplatin 40 mg/m², and then weekly cetuximab. DL2 consisted of radiotherapy plus cetuximab 200 mg/m² and cisplatin 30 mg/m². DL3 was made up of radiotherapy plus cetuximab 250 mg/m² and cisplatin 30 mg/m².

In addition, patients underwent ¹⁸F-FDG-PET/CT before treatment, after neoadjuvant cetuximab, and at the end of treatment.

Twenty-one patients were enrolled in the study, of which nine, three, and nine were treated in DL1, DL2, and DL3, respectively. Dose reductions were performed in DL1 because of gastrointestinal toxicities. DL2 and DL3 were well tolerated, with one dose-limiting toxicity (grade 4 renal failure) at the latter dose.

Seven patients in DL1 had maximum standardized uptake value changes on ¹⁸F-FDG-PET/CT consistent with response to cetuximab after three weekly treatments of neoadjuvant cetuximab.

Eleven of the 12 patients with locally advanced disease showed no evidence of disease on ¹⁸F-FDG-PET/CT at treatment end. Five-year progression-free survival and overall survival rates were 57.5 percent and 58.5 percent, respectively, for all patients.

“With advances in precision oncology and the recent approval of pembrolizumab in metastatic cervical cancer, dual-target inhibition with an epidermal growth factor receptor inhibitor may be a promising treatment in the future,” the researchers said.