Current Standards in the Management of Early and Locally Advanced Cervical Cancer: Update on the Benefit of Neoadjuvant/Adjuvant Strategies.

Yuedan Zhou , Elie Rassy (1, 2) , Alexandre Coutte (3, 4) , Samir Achkar , Sophie Espenel (5) , Catherine Genestie (6) , Patricia Pautier (6, 2) , Philippe Morice (6) , Sébastien Gouy (6, 7, 8) , Cyrus Chargari (6, 9, 8)

1 Département d'hématologie [Gustave Roussy]
2 Département de médecine oncologique [Gustave Roussy]
3 CHU Amiens-Picardie
4 CHIMERE - CHirurgie, IMagerie et REgénération tissulaire de l’extrémité céphalique - Caractérisation morphologique et fonctionnelle - UR UPJV 7516
5 Institut de Cancérologie de la Loire Lucien Neuwirth
6 IGR - Institut Gustave Roussy
7 Pôle chirurgical et interventionnel [Gustave Roussy]
8 RaMo-IT - Radiothérapie Moléculaire et Innovation Thérapeutique
9 Département de radiothérapie [Gustave Roussy]

Globally, cervical cancers continue to be one of the leading causes of cancer-related deaths. The primary treatment of patients with early-stage disease includes surgery or radiation therapy with or without chemotherapy. The main challenge in treating these patients is to maintain a curative approach and limit treatment-related morbidity. Traditionally, inoperable patients are treated with radiation therapy solely and operable patients undergo upfront surgery followed by adjuvant (chemo) radiotherapy in cases with poor histopathological prognostic features. Patients with locally advanced cervical cancers are treated with concurrent chemoradiotherapy followed by an image-guided brachytherapy boost. In these patients, the main pattern of failure is distant relapse, encouraging intensification of systemic treatments to improve disease control. Ongoing trials are evaluating immunotherapy in locally advanced tumours following its encouraging efficacy reported in the recurrent and metastatic settings. In this article, clinical evidence of neoadjuvant and adjuvant treatments in cervical cancer patients is reviewed, with a focus on potential strategies to improve patients' outcome and minimize treatment-related morbidity.

Domaines: Sciences du Vivant [q-bio]

Yuedan Zhou, Elie Rassy, Alexandre Coutte, Samir Achkar, Sophie Espenel, et al.. Current Standards in the Management of Early and Locally Advanced Cervical Cancer: Update on the Benefit of Neoadjuvant/Adjuvant Strategies.. Cancers, 2022, 14 (10), ⟨10.3390/cancers14102449⟩. ⟨hal-03686656⟩