A noninferiority trial conducted by investigators from Japan, JCOG0505, evaluated cisplatin and paclitaxel compared with carboplatin and paclitaxel in 253 women with advanced or metastatic cervical cancer. Results from the intent-to-treat population showed similar survival outcomes between the two regimens, suggesting that carboplatin may be interchangeable with cisplatin (HR, 0.994; P = .032).
This was an important study that changed the standard of care, notes Angeles Alvarez Secord, MD. However, a prespecified subgroup analysis showed that individuals who were cisplatin-naïve and treated with the carboplatin-containing regimen had a worse survival outcome. In this analysis of cisplatin-naïve patients, carboplatin and paclitaxel showed an overall survival of 13 months compared with 23.2 months for those treated with cisplatin and paclitaxel (HR, 1.571).