Will you be changing your management of locally advanced cervical cancer based on the results of the recently published INTERLACE trial?
Do you plan on incorporating induction chemotherapy into the treatment of patients with locally advanced cervical cancer?
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Absolutely NOT. INTERLACE results are in abstract form only, including early-stage disease I-II at 86%, and the details regarding radiation are minimal, stating it's prescribed to point A and recommend CT/MR planning (we do not know how many patients underwent image-guided brachytherapy).
Also, induction or neoadjuvant chemo is not new for the cervix, and in the past, it never impacted survival; Miriyala et al., PMID 35256411.
The rampant advertising as the standard of care (SOC) for the cervix is very worrisome, especially since with quality brachytherapy, we have a currently vetted standard with excellent results, as per EMBRACE II, upfront Cis/RT with image-guided brachytherapy.
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I think it is too early to commit all patients to induction chemo, based on what I know about this study. It is important to review the details of the study, as mentioned by Dr. @Dr. First Last. In addition, it is important to understand the differences between studies that led to an overall survival benefit in this study, as compared to other studies that showed less to no benefit. Finally, the added toxicities of treatment such as neurotoxicity and myelosuppression have to be factored into the equation in terms of trying to achieve the optimal therapeutic ratio. Patients themselves should have a voice and have the opportunity to understand the data as well as the pros and cons of a more toxic treatment approach.
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I would wait for the publications for details including brachytherapy and recurrence pattern but could potentially be practice-changing.
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