Chemoradiotherapy does not improve overall survival (OS), compared with chemotherapy alone, in patients with locally advanced endometrial cancer, a phase 3 trial suggests.  

These results were presented at the 2023 SGO Annual Meeting on Women’s Cancer by Daniela E. Matei, MD, of Northwestern University in Chicago.

The phase 3 trial (NRG258; ClinicalTrials.gov Identifier: NCT00942357) enrolled patients with stage I-IVA endometrial cancer. All patients underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy.


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After surgery, patients were randomly assigned to receive chemoradiotherapy (n=370) or chemotherapy alone (n=366). Patients in the chemoradiotherapy arm received 2 courses of cisplatin plus volume-directed radiation (45 Gy with or without brachytherapy), followed by 4 cycles of carboplatin plus paclitaxel. The chemotherapy-only arm received 6 cycles of carboplatin plus paclitaxel. 

The primary endpoint was recurrence-free survival (RFS). As previously reported, the RFS was similar between the treatment arms (hazard ratio [HR], 0.90; 90% CI, 0.74-1.10; P =.20). 

At a median follow-up of 112 months, OS was also similar between the arms (HR, 1.05; 95% CI, 0.82-1.34). There were 134 fatalities in the chemoradiotherapy arm and 125 in the chemotherapy-alone arm. 

“Chemoradiotherapy did not improve overall survival in any of the subgroups analyzed,” Dr Matei noted.  

She also pointed out that prior results showed no improvement in progression-free survival with chemoradiotherapy. However, chemoradiotherapy was associated with a reduction in local recurrences. 

Disclosures: Dr Matei declared affiliations with AstraZeneca, CVS Health, Elsevier, GlaxoSmithKline, Merck, and PinotBio.

Reference

Matei DE, Enserro D, Kudrimoti M, et al. Overall survival in NRG258, a randomized phase III trial of chemo-radiation vs. chemotherapy alone for locally advanced endometrial carcinoma. SGO 2023. March 25-28, 2023.