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Adding chemotherapy to recurrent endometrial cancer is not good

NEW YORK–Women with recurrent endometrial cancer did not benefit from weekly cisplatin chemotherapy in addition to standard radiation therapy, according to the results of a randomized trial.

Among patients who received cisplatin-based chemotherapy concurrently with RT, 57.3% were alive and progression-free, compared with 68% of patients who received definitive RT alone—in study During a median of 5 years, the chemotherapy group had relatively poorer outcomes at 50% follow-up, although this difference was not statistically significant (P=0.8).

There was no difference in overall survival (OS) between the two cohorts, according to data provided by Ann Klopp, MD, of the University of Texas MD Anderson Cancer Center, International Gynecologic Cancer Center, in Data cutoff was 75.6% and 78.6% respectively at the Annual Meeting of the Society for Survival (IGCS).

“Adding concurrent chemotherapy did not improve outcomes for patients with definitive radiotherapy for recurrent endometrial cancer,” Klopp said. She added that these results apply to patients with low-grade tumors and vaginal apex development, as this population constitutes the majority of trial participants.

This is the first prospective trial to demonstrate durable long-term survival after radiation therapy in patients with recurrent endometrial cancer, Klopp added, noting that the study demonstrated value of randomized trials for less common manifestations.

Radiation therapy alone remains Carol Aghajanian, MD, of Memorial Sloan Kettering Cancer Center in New York City, concludes IGCS session discussant discussing pelvic-only, vaginal cuff intrauterine Membrane cancer recurrence care.

She suggested that the inclusion of low-grade disease in this trial could be evidence of selection bias if those with high-grade cancer were encouraged to receive chemotherapy rather than randomisation. Or it may just be that recurrent endometrial cancer of the pelvis is more common, she added. There are still relapses.

The pelvis is a common site of recurrence of endometrial cancer, Klopp said. Previous studies have shown that definitive-dose radiation therapy can cure patients with isolated relapses, with 50-70 percent of patients surviving five years after treatment for relapsed disease, she added.

In the GOG-0238 trial, researchers evaluated whether the addition of concurrent chemotherapy could improve progression-free survival in patients with recurrent endometrial cancer. The trial enrolled 165 participants with recurrent endometrial cancer confined to the pelvis between February 2009 and August 2020.

Patient received radiation therapy to the entire pelvis with 3D or IMRT, followed by low-dose-rate or high-dose-rate interstitial or intracavitary brachytherapy. Participants in the intervention group received 40 mg of cisplatin-based chemotherapy weekly.

The mean age of trial participants was approximately 65 years, and the majority were white. About 81% of trial participants had grade I or II endometrial cancer, and 86% of recurrences were vaginal cancer.

Klopp acknowledged the slow recruitment of the trial, noting that patients may have been offered concomitant chemotherapy outside of the protocol as clinicians deemed benefit. During the study period, the trial protocol also changed, which may have affected accruals.

  • Amanda D’Ambrosio is a reporter for MedPage Today’s Corporate and Investigations team. She reports on obstetrics and other clinical news, and writes features on the U.S. healthcare system. Follow


    Klopp’s disclosures with Boston Scientific and Aspen Likang’s relevant financial relationships.

    Aghajanian reports relationship with AstraZeneca/Merck and Repare Therapeutics.



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