<p>Long-Term Results of Concurrent Chemoradiotherapy Combined with Anti-EGFR Monoclonal Antibody Prior to Surgery in Locally Advanced Cervical Cancer: A Single-Institute Prospective Study</p>

Abstract

We aimed to evaluate the long-term survival outcomes of concurrent chemoradiotherapy (CCRT) combined with nimotuzumab followed by surgery in patients with locally advanced cervical cancer (LACC). Patients and Methods: Patients received whole pelvic intensity-modulated radiation therapy (IMRT) and concomitantly with weekly cisplatin (40 mg/m 2) or nedaplatin (30 mg/m 2) and weekly nimotuzumab (200 mg). After assessment of the treatment response, patients then underwent radical surgery. Results: Between June 2013 and July 2016, 33 patients with FIGO IB2-IIIB cervical cancer were recruited. Clinical complete response and partial response were observed in 8 (24.3%) and 23 patients (69.7%), respectively. Twenty-seven patients (81.8%) were successfully treated with radical hysterectomy and pelvic lymphadenectomy: 9 (33.3%) showed pathological complete response; 10 (37.1%) showed partial response and 8 (29.6%) presented with persistent macroscopic/microscopic residual carcinoma. For the intention-to-treat population, the median follow-up time was 53.7 months. Locoregional recurrence and distant metastases were observed in three and seven patients, respectively. The 5-year overall survival, progression-free survival, locoregional recurrence-free survival, and distant metastasis-free survival were 81.5%, 72.7%, 90.9%, and 78.3%, respectively. Both acute and late toxicities were manageable and mainly limited to grade 1 or 2. Conclusion: Concurrent chemoradiotherapy combined with nimotuzumab followed by surgery for patients with LACC is safe and results in excellent long-term treatment outcomes. Further randomized controlled studies are warranted to confirm the findings.

Prediction of the Mechanisms by Which Quercetin Enhances Cisplatin Action in Cervical Cancer: A Network Pharmacology Study and Experimental Validation

“…Meanwhile, it has also been reported that TGF-α and amphiregulin inhibit the Hippo signaling pathway and activate YAP through EGFR to induce the proliferation and migration of cervical cancer cells ( 51 ). Two prospective studies revealed that cisplatin combined with anti-EFGR monoclonal antibody followed by surgery in locally advanced cervical cancer patients leads to excellent treatment outcomes ( 52 , 53 ). ERBB2 is another important therapeutic target of the epidermal growth factor receptor family in the treatment of malignant tumors ( 54 ).…”

Changes of T Lymphocyte Subsets in Peripheral Blood of Patients with Intermediate and Advanced Cervical Cancer before and after Nimotuzumab Combined with Chemoradiotherapy

“…The levels of CA125, SCCA, and CEA in the Nimo + CRT group were further lower than those in the CRT alone group. Consistently, Nimo combination therapy had better long-term efficacy in patients with locally advanced CC [23]. In brief, Nimo combined CRT has better therapeutic effects on patients with IACC.…”

Nimotuzumab combined with chemoradiotherapy for the treatment of cervical cancer: A meta-analysis of randomized controlled trials

“…The results showed that nimotuzumab in combination with CCRT for LACC resulted in a prolonged PFS and higher rates of complete remission without an increased incidence of adverse events ( 35 ). A single-arm study evaluating the efficacy of preoperative CCRT in combination with nimotuzumab in patients with LACC found that preoperative CCRT plus nimotuzumab achieved good local tumour control with acceptable toxicity ( 17 ).…”

“…It has been demonstrated that a combination of anti-EGFR monoclonal antibody and radiotherapy enhances the antitumour effect by increasing the cytotoxic effect of radiation and enhancing the inhibition of EGFR signalling (16). Another single-arm study by Qing et al also showed that neoadjuvant chemoradiotherapy (CRT) plus nimotuzumab combined with surgery was safe for patients with LACC and had good long-term outcomes (17).…”

“…Another single-arm study by Qing et al. also showed that neoadjuvant chemoradiotherapy (CRT) plus nimotuzumab combined with surgery was safe for patients with LACC and had good long-term outcomes ( 17 ).…”