The Impact of Systemic Therapy Beyond First-line Treatment for Advanced Cervical Cancer

Area of Science:

• Gynecologic Oncology
• Medical Oncology
• Clinical Pharmacology

Background:

• Cervical cancer recurrence and metastasis remain significant challenges despite advances in primary and secondary prevention.
• Optimal second-line systemic therapy for recurrent/metastatic cervical cancer lacks established consensus.
• This study evaluates treatment patterns and outcomes in a real-world setting.

Purpose of the Study:

• To determine the types of second-line systemic treatments administered to patients with recurrent/metastatic cervical cancer.
• To assess the efficacy of these second-line therapies, including objective response rate (ORR), progression-free survival (PFS), and overall survival (OS).

Main Methods:

• Retrospective review of 75 patients with cervical cancer treated at a single institution (2004-2014).
• Focus on 53 patients who received second-line systemic therapy for recurrent or metastatic disease.
• Data collection included treatment types, ORR, PFS, and OS.

Main Results:

• Weekly paclitaxel was the most frequent second-line therapy (28.3%), followed by carboplatin-based chemotherapy (24.5%) and targeted agents in clinical trials (22.6%).
• Overall response rate to second-line therapy was low at 13.2%, with 41.5% achieving stable disease at 4 months.
• Median PFS was 3.2 months, and median OS was 9.3 months for patients receiving second-line treatment.

Conclusions:

• A significant proportion (70.7%) of patients with recurrent/metastatic cervical cancer receive second-line therapy, but response rates are generally poor.
• There is an unmet need for a standard of care in second-line treatment for advanced cervical cancer.
• Enrollment in clinical trials investigating novel targeted agents and immunotherapies is strongly encouraged for eligible patients.