IGCS 2024 Cervical Master Sessions: Moving Forwards-Part 2

Video Transcription

Video Summary

The session focused on the treatment and management of cervical cancer, specifically locally advanced and metastatic cases. Dr. Supriya Chopra, a radiation oncologist from India, chaired the session with co-chairs Dr. Alexandra Leary, Dominica LoRusso, and Dr. Glenn McClurg. The first part, moderated by Dr. Chopra and Dr. LoRusso, covered locally advanced cervical cancer, with a case presentation by Florencia Noll from Argentina, who discussed a 28-year-old patient with a differentiated squamous cell carcinoma, highlighting the treatment plan of concurrent chemoradiation and the successful management of residual disease. Dr. Alexandra Taylor discussed advances in modern radiotherapy techniques, emphasizing the use of image-guided brachytherapy and intensity-modulated radiotherapy to improve outcomes by enhancing tumor control and reducing toxicity. She highlighted how these advancements lead to better long-term control and allow for the potential salvage of recurrent disease. Dr. Mary McCarnick presented the INTeRLACE trial, showing significant improvement in survival with induction chemotherapy before standard chemoradiation in patients with locally advanced cervical cancer. The trial achieved statistically significant outcomes, suggesting induction chemotherapy could become standard in treatment. Dr. Dominica LoRusso discussed a trial updating the use of pembrolizumab in conjunction with chemoradiation for locally advanced cervical cancer, demonstrating a 33% reduction in the risk of progression and the potential to set new standards in treatment. Dr. Janice Balega examined the role of surgery in these cases, noting limited evidence for neoadjuvant chemotherapy plus surgery and advocating for expert centers in managing salvage cases. In the session's second half, transitioning to metastatic cervical cancer, Dr. Anissa Mumbru presented a case involving a 42-year-old patient with metastatic disease. The focus shifted to treatment options like palliative chemotherapy and the potential role of radiotherapy in metastatic settings. Dr. Ana Ocman updated on the BEAT-CC trial, indicating the benefit of combining atezolizumab with bevacizumab and chemotherapy for metastatic cervical cancer, resulting in improved progression-free survival. Dr. Rupali Arora discussed the reliability of PD-L1 testing, underlining its importance in determining patient suitability for immunotherapies. Dr. Keishi Fujiwara presented findings on Tisotumab vedotin, demonstrating its efficacy after first-line therapy. The session concluded with a discussion, addressing questions about the role of immune checkpoint inhibitors in HIV and tuberculosis.

Keywords

cervical cancer

locally advanced

metastatic

chemoradiation

image-guided brachytherapy

intensity-modulated radiotherapy

INTeRLACE trial

pembrolizumab

neoadjuvant chemotherapy

atezolizumab

PD-L1 testing

Tisotumab vedotin