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Poster/ePoster Sessions
01. Cervical cancer
#953 Neoadjuvant dose-dense chemotherapy with carboplatin and paclitaxel in FIGO 2018 stage IB1-IIA2 cervical cancer
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  1. Simone Bruni1,
  2. Maria Teresa Lapresa2,
  3. Gabriella Parma2,
  4. Silvia Derio2,
  5. Isabella Lorenzetti2,
  6. Fedro Peccatori3,
  7. Ilaria Betella1,
  8. Gabriella Schivardi1,
  9. Luigi De Vitis1,
  10. Giuseppe Caruso1,
  11. Giovanni Aletti1,4,
  12. Benedetta Zambetti5,
  13. Vanna Zanagnolo1,
  14. Angelo Maggioni1,
  15. Nicoletta Colombo1,5 and
  16. Francesco Multinu1
  1. 1IEO, European Institute of Oncology IRCCS, Division of Gynecologic Surgery, Milan, Italy
  2. 2IEO, European Institute of Oncology IRCCS, Gynecologic Oncology, Milan, Italy
  3. 3IEO, European Institute of Oncology IRCCS, Fertility and Procreation Unit, Division of Gynecologic Oncology, Milan, Italy
  4. 4Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
  5. 5University of Milan-Bicocca, Gynecologic Oncology Program, Milan, Italy

Abstract

Introduction/Background In FIGO stages IB1-IB2 and IIA1 cervical cancer with suspected cervical stromal ring disruption on preoperative evaluation, radical surgery is indicated even though there is an increased risk of adjuvant chemo-radiotherapy (CCRT). While exclusive CCRT represents the gold standard for FIGO stages IB3/IIA2, subgroup analysis restricted to these stages of studies comparing CCRT vs neoadjuvant chemotherapy (NACT) showed similar outcomes between the two groups. The primary aim of this study is to evaluate the role of dose-dense NACT with carboplatin and paclitaxel in patients with FIGO stage IB1-IB2/IIA1 with preoperative stromal ring disruption or IB3-IIA2.

Methodology Patients with FIGO stages IB1-IIA2 undergoing dose-dense NACT at the European Institute of Oncology, Milan from 07/2014 to 12/2022 were retrospectively identified. They received weekly dose-dense carboplatin + paclitaxel for 6–9 cycles followed by radical surgery or CCRT, depending on radiologic response as assessed by RECIST criteria. Predictors of radiologic response to NACT and follow-up data were evaluated with appropriate statistical analysis.

View this table:
Abstract #953 Table 1

Univariate analysis of predictors of response to dose-dense at imaging (n=64). Abbreviations: CBDCA, carboplatin; PTX, paclitaxel; SD, standard deviation.

Results A total of 64 patients meeting inclusion criteria were included. Radiological response to NACT were the following: 10(15,6%) complete response, 41(64,0%) partial response, 11(17,0%) stable disease, and 2(3,1%) progressive disease. None of the evaluated factors were associated with radiological response to NACT (table 1). After multidisciplinary team discussion, 6 (9,4%) patients were deemed inoperable and received CCRT. Among the remaining 58 (90,6%) patients undergoing surgery, 14 (24,1%) underwent CCRT, 2 (3,4%) radiotherapy alone, and 7 (12,1%) chemotherapy alone, while the remaining 35 (60,3%) were observed. Overall, NACT followed by surgery allowed us to avoid radiotherapy in 42 (65.6%) patients. Among them, during a median follow-up time of 52 months (range 6–94), 5 (11,3%) patients experienced a recurrence.

Conclusion Dose-dense NACT achieved a good response rate and could be considered an alternative approach, especially in young patients desiring to avoid radiotherapy.

Disclosures No conflict of interest for all the authors

https://doi.org/10.1136/ijgc-2023-ESGO.209

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