Transformative clinical trials in gynaecologic radiation oncology in 2023-2024: Shaping modern treatment practices.

Autor: El Ayachi Z; Radiation Oncology Department, groupe hospitalier universitaire Pitié-Salpêtrière, Sorbonne Université, 75013 Paris, France., Gabro A; Radiation Oncology Department, groupe hospitalier universitaire Pitié-Salpêtrière, Sorbonne Université, 75013 Paris, France., Camprodon G; Radiation Oncology Department, groupe hospitalier universitaire Pitié-Salpêtrière, Sorbonne Université, 75013 Paris, France., Chopra S; Department of Radiation Oncology and Medical Physics, Advanced Centre for Treatment Research and Education in Cancer, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India., Maingon P; Radiation Oncology Department, groupe hospitalier universitaire Pitié-Salpêtrière, Sorbonne Université, 75013 Paris, France., Chargari C; Radiation Oncology Department, groupe hospitalier universitaire Pitié-Salpêtrière, Sorbonne Université, 75013 Paris, France. Electronic address: cyrus.chargari@aphp.fr.
Jazyk: angličtina
Zdroj: Cancer radiotherapie : journal de la Societe francaise de radiotherapie oncologique [Cancer Radiother] 2024 Dec; Vol. 28 (8), pp. 719-726. Date of Electronic Publication: 2024 Nov 22.
DOI: 10.1016/j.canrad.2024.10.002
Abstrakt: The field of gynaecologic oncology has evolved rapidly in recent years, largely driven by advances in both radiotherapy and systemic therapies. These innovations have reshaped the management of key gynaecologic cancers, including cervical, endometrial, vaginal, and vulvar cancers, leading to more personalized and effective treatment approaches. This review explores pivotal clinical trials conducted between 2023 and 2024 that have potentially modified current practices. Through an extensive analysis of randomized controlled trials and meta-analyses, we examine the evolving role of radiotherapy, the integration and sequencing of immunotherapy, and the refinement of neoadjuvant and adjuvant treatments based on molecular classifications. The combination of immunotherapy with chemoradiotherapy has shown promising outcomes, particularly in patients with locally advanced cervical cancer. For endometrial cancer, molecular profiling has enabled a more precise classification of tumour subtypes, leading to better-targeted adjuvant therapies that reduce unnecessary interventions and increase treatment efficacy. In parallel, radiotherapy has advanced with the increasing use of modern techniques such as intensity-modulated radiotherapy and more recently the developments of adaptive treatments in order to minimize exposure to healthy tissue, thereby reducing toxicity and enhancing patient quality of life. Integration of image-guided brachytherapy and expansion of capabilities with newer generation of brachytherapy applicators have also increased possibilities to achieve efficient local treatments, including in very advanced cases. However, despite progress in common gynaecologic cancers, the management of rare cancers such as vulvar and vaginal cancers continues to face challenges due to limited clinical research and treatment data. This review highlights the transformative potential of these innovations and emphasizes the need for continued research and personalized treatment strategies to optimize patient outcomes in gynaecologic oncology.
Competing Interests: Disclosure of interests CC reports personal fees and non-financial support from MSD, EISAI, GSK, Merck, support for travelling by Ipsen, and service as an investigator for clinical trials sponsored or supported by TherAgulX and Roche; ZEA, AG, GC, SC, PM have not declared their activities/relationships/interests.
(Copyright © 2024 Société française de radiothérapie oncologique (SFRO). Published by Elsevier Masson SAS. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: