Evolving Systemic Intensification Strategies Beyond CCRT in Locally Advanced Cervical Cancer.
- 1Department of Radiation Oncology, Peking University First Hospital, Beijing, People's Republic of China.
Abstract
Concurrent chemoradiotherapy (CCRT) remains the standard of care for locally advanced cervical cancer (LACC); however, 30-40% of patients experience recurrence, prompting evaluation of systemic treatment intensification to improve outcomes over CCRT alone. This critical review synthesizes evidence from PubMed, Embase, and the Cochrane Library up to January 2026, evaluating clinical trials of intensification strategies categorized by treatment timing: neoadjuvant, concurrent, and adjuvant modalities. Historical attempts to intensify treatment through adjuvant chemotherapy have failed to confer survival benefits with the regimens studied, often increasing toxicity without efficacy (OUTBACK). However, recent Phase III trials have reported survival benefits with specific treatment regimens. Specifically, induction chemotherapy followed by CCRT (INTERLACE) and pembrolizumab with CCRT followed by maintenance (KEYNOTE-A18) have demonstrated significant improvements in overall survival, whereas additional concurrent cytotoxic agents have not consistently improved outcomes and may increase toxicity. CCRT remains the cornerstone; intensification should follow the tested regimen, eligibility criteria, and toxicity profile. PD-L1-based selection and the independent benefit of adjuvant immunotherapy require further validation.
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BibTeX
@article{cheng2026evolving,
title = {{Evolving Systemic Intensification Strategies Beyond CCRT in Locally Advanced Cervical Cancer.}},
author = {Tian Cheng and Ruoyu Niu and Xiaomei Li and Xianshu Gao and Jiayan Chen},
journal = {Cancer management and research},
year = {2026},
month = oct,
doi = {10.2147/cmar.s637635},
url = {https://europepmc.org/article/MED/42968957},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Evolving Systemic Intensification Strategies Beyond CCRT in Locally Advanced Cervical Cancer.
AU - Tian Cheng
AU - Ruoyu Niu
AU - Xiaomei Li
AU - Xianshu Gao
AU - Jiayan Chen
PY - 2026
DA - 2026/10/28
JO - Cancer management and research
DO - 10.2147/cmar.s637635
UR - https://europepmc.org/article/MED/42968957
AB - Concurrent chemoradiotherapy (CCRT) remains the standard of care for locally advanced cervical cancer (LACC); however, 30-40% of patients experience recurrence, prompting evaluation of systemic treatment intensification to improve outcomes over CCRT alone. This critical review synthesizes evidence from PubMed, Embase, and the Cochrane Library up to January 2026, evaluating clinical trials of intensification strategies categorized by treatment timing: neoadjuvant, concurrent, and adjuvant modalities. Historical attempts to intensify treatment through adjuvant chemotherapy have failed to confer survival benefits with the regimens studied, often increasing toxicity without efficacy (OUTBACK). However, recent Phase III trials have reported survival benefits with specific treatment regimens. Specifically, induction chemotherapy followed by CCRT (INTERLACE) and pembrolizumab with CCRT followed by maintenance (KEYNOTE-A18) have demonstrated significant improvements in overall survival, whereas additional concurrent cytotoxic agents have not consistently improved outcomes and may increase toxicity. CCRT remains the cornerstone; intensification should follow the tested regimen, eligibility criteria, and toxicity profile. PD-L1-based selection and the independent benefit of adjuvant immunotherapy require further validation.
SN - 1179-1322
ER -