Survival Outcomes of Metastatic or Recurrent Cervical Cancer Patients Treated with Palliative Intent Chemotherapy: Real-World Data

Objective: To analyse the outcomes of metastatic or recurrent cervical cancer patients treated with palliative intent chemotherapy, as data on their outcomes are scant from LMIC. Methods: In this retrospective analysis, 302 upfront metastatic or recurrent cervical cancer patients were treated with palliative intent from 1 January 2015 till 31 March 2020. The demographics, palliative therapy details, progression-free survival (PFS) and overall—survival (OS) were analysed for those receiving chemotherapy. Results: The median age was 53 (IQR 48-61) years and 248, (82.0 %) patients belonged to low-socioeconomic strata. Most common histology was squamous cell carcinoma (SCC) in 263 (87.1%) patients. De novo metastatic disease was seen in 119 (39.4 %) and recurrence post-treatment was seen in 183 (60.6 %) patients. Among the 302 patients, 149 (49.3%) patients received palliative chemotherapy, 70 (23.2 %) received palliative radiotherapy and 83 (27.5%) patients were considered for palliative care alone. The most common regimen was paclitaxel and carboplatin in 124 (83.2 %) patients. Eighty (53.7 %) patients completed 6 cycles. Four (2.7 %) received bevacizumab with chemotherapy in the first line and 3 (2.0%) patients received pembrolizumab in second line. The median PFS was 8.5 months (95% CI: 7.12–9.89 months) and median OS was 13.0 months (95% CI: 11.10–14.98 months) with median duration of follow-up of 33.4 months (range 27.9–38.9 months). Conclusions: In real-world scenario, only half of the metastatic or recurrent cervical patients received any palliative chemotherapy. Paclitaxel and carboplatin are an effective regimen, and there was limited access to targeted therapy and immunotherapy.