The KEYS trial and OUTBACK trial both investigated adding adjuvant chemotherapy to chemoradiation in locally advanced cervical cancer. What was the primary finding of the OUTBACK trial?
- A Addition of adjuvant carboplatin-paclitaxel improved overall survival
- B Adjuvant chemotherapy did not improve overall survival and increased toxicity ✓
- C Addition of adjuvant bevacizumab improved progression-free survival
- D Adjuvant chemotherapy reduced distant metastases significantly
Correct answer: B. Adjuvant chemotherapy did not improve overall survival and increased toxicity
Explanation
The OUTBACK trial (2022) randomised 919 women with locally advanced cervical cancer (Stage IB1 node-positive to Stage IVA) to concurrent cisplatin chemoradiation plus brachytherapy versus the same followed by 4 cycles of adjuvant carboplatin-paclitaxel. At 5 years, there was no difference in overall survival (72% vs 71%) and the adjuvant chemotherapy arm had significantly greater toxicity. This does not support adding adjuvant chemotherapy after standard chemoradiation.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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