About this trial
A total of 112 patients with locally advanced cervical cancer will be randomized 1:1 to standard therapy with cisplatin-based chemoradiation or nivolumab-ipilimumab induction followed by cisplatin-based chemoradiation. The primary outcome will be 3-year disease-free survival.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Female participants older than 18 years
Documented evidence of cervical adenocarcinoma or squamous carcinoma FIGO Stage IB2-IB3 node positive or Stage IIB-IVA
No prior chemotherapy, immune checkpoint inhibitors or radiotherapy for cervical cancer
WHO/ECOG performance status of 0-1
Disqualifiers
Diagnosis of small cell (neuroendocrine) histology cervical cancer
Intent to administer a fertility-sparing treatment regimen
Undergone a previous hysterectomy
Evidence of metastatic disease per RECIST 1.1 including lymph nodes ≥15 mm (short axis) above the L1 cephalad body or outside the planned radiation field.
Trial design
Parallel
Treatments tested in this trial
Nivolumab 40 mg in 4 ml Injection
DrugNivolumab 1mg/kg every 3 weeks for 4 cycles prior to radiation and 240mg every 2 weeks with concurrent radiation
Ipilimumab 200 MG in 40 ML Injection
DrugIpilimumab 3mg/kg every 3 weeks for 4 cycles prior to radiation
Chemoradiation
RadiationRadiation to a dose of 45Gy over 25 1.8Gyfractions and brachytherapy with concurrent weekly cisplatin 40mg/m2/w or carboplatin AUC 2/w
Treatment groups
Trial outcomes
Primary outcomes
3-year progression-free survival
No evidence of disease recurrence/regrowth after 3 years of follow-up
Secondary outcomes
3-year overall survival
Rate of survival 3 years after the end of chemoradiation
Objective response rate
RECIST response
Response duration
Time from maximum response to disease progression
To evaluate health related quality of life (HRQoL): defined as the change from baseline of disease-related symptoms and quality of life of patients undergoing treatment Nivolumab-ipilimumab and Chemoradiation for Cervical Cancer
Evaluate health related quality of life using the instrument EORTC QLQ-C30 v3 based on European Organization for Research and Treatment of Cancer (EORTC). The EORTC QLQ-C30 v3 questionnaire, consisting of 30 questions covering 15 domains, divided into three distinct scales: state scale global health and quality of life (it has only one domain, global health measure); functional scale (physical function, role performance, emotional function, cognitive function and social function domains); and symptom scale (fatigue, nausea and vomiting, pain, dyspnea, insomnia, loss of appetite, constipation, diarrhea and financial difficulties). The scores on each scale range from 0 - 100. The global and functional health scales indicate better quality of life as their score approaches 100. For the symptoms scale, the analysis is inverse, with better performance for quality of life when the scores approach the score minimum (zero).
Sponsors and contacts
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