ESMO 2023 | Dr. McCormack analyzes the impact of the INTERLACE trial on the treatment of locally advanced cervical cancer
Oncology
Frontier: Please introduce yourself, including your name, profession and where are
you from?
Dr McCormack: My name is Mary McCormack. I am a
consultant clinical oncologist. I work at University College London Hospital
where my major interest is gynecological cancers, including all aspects of
chemotherapy and radiotherapy. I am a past-Chair of the GCIG (Gynecological
Cancer Intergroup) Cervical Cancer Research Network, and I am also a past
member of the International Affairs Committee for ASCO. But I am passionate
about cervical cancer.
Oncology Frontier: 2023 ESMO released the data of phase III trial of induction chemotherapy followed by chemoradiation compared with chemoradiation alone in locally advanced cervical cancer（LBA8）. Please share your views on the results from GCIG INTERLACE trial.
Dr McCormack: INTERLACE was a randomized phase III trial
of a short course of chemotherapy given weekly with carboplatin-paclitaxel, and
then followed immediately by the standard chemoradiation. It was compared
against the standard chemoradiation alone. We recruited 500 patients, and what
we found was for that patients who were given the additional chemotherapy, it
improved the progression-free survival rate by 9%. There was an 8% improvement
in overall survival rate at five years. Of course, this is the first time in
almost 25 years that we have had a potential practice-changing result in
cervical cancer that is ready to go to the clinic.
Oncology Frontier: what's the current and future directions of IO in combination with chemoradiation therapy in locally advanced cervical cancer.
Dr McCormack: The KEYNOTE-A18 study was presented a
couple of days ago (Friday afternoon), and that was looking at pembrolizumab in
patients with high-risk locally advanced disease. The follow-up is still quite
short on that study I think, but the results look promising. It is hoped that
will be another treatment option for patients. However, with immunotherapy in
the frontline setting, all of the studies have had very long maintenance phases
after the standard-of-care treatment, so we have to think about what compliance
might be like with individuals having to stay on treatment for nearly two years
after they finish the chemoradiation. Of course, we will have to consider and
factor in the cost and how it will be affordable, because it is not going to be
cheap. But it is wonderful to have these options for our patients. It is really
a great week for cervical cancer patients.
Oncology Frontier: The 2023 ESMO has released the results of a number of gynecologic cancer studies,which studies are you most interested in?
Dr McCormack: I am very interested in the study that
Professor Vergote just reported on, looking at tisotumab vedotin, the
antibody-drug conjugate (ADC). This is a really interesting group of drugs. We
get away a little bit from PD-L1 and PD-1 from the checkpoint inhibitors. As a
single agent, it has shown really very good results in second-line treatment.
It will be nice to see this moving forward into perhaps using it in first-line
as well. The data are impressive from that study, so I think that is really
great news for our patients. Currently, there are a lack of options beyond
first-line. We have cemiplimab in the second-line setting, but the response rate to this drug alone
is better than chemotherapy, but it is still not great. There are still a lot
of patients who don’t actually benefit. So it is wonderful to have another drug
that is even more effective. I am very excited for tisotumab vedotin.
,