Desensitization protocols for platinum-based chemotherapy in metastatic cervical cancer: Real-world survival outcomes comparable to global trials.

Abstract

e23089 Background: Metastatic cervical cancer remains a treatment challenge, as effective therapies are limited and the prognosis is poor. While platinum-based chemotherapy is the preferred first-line option, hypersensitivity reactions can disrupt treatment and cause delays in care.Desensitization protocols allow patients to safely continue therapy; however, their impact on progression-free survival (PFS) and tolerability remains understudied. This study evaluates PFS outcomes, treatment-related adverse events, and the success of desensitization protocols in this setting. Methods: A retrospective analysis was conducted on 22 patients with metastatic cervical cancer who underwent desensitization for systemic therapy at a single institution. PFS, time from treatment start to progression or death, was estimated using Kaplan-Meier survival analysis. Secondary endpoints included the progression rate, treatment-related toxicities (graded per CTCAE v5.0), and desensitization success rate. Results were compared to benchmarks from pivotal trials, including GOG-0213 and KEYNOTE-826. Results: The cohort had a median follow-up of 44 weeks, with a median PFS of 10 months. The progression rate was 42.9%, aligning with global standards for metastatic cervical cancer. Desensitization was successful in 100% of cycles, with no discontinuations due to hypersensitivity. Toxicities were primarily mild: Grade 1–2 nausea (59.1%) and anemia (27.3%) were the most frequent. Grade 3–4 toxicities, including neutropenia (22.7%) and anemia (13.6%), were less common, reflecting the protocol’s tolerability. In comparison, GOG 0213 reported a median follow-up of 49 months with a PFS of 10 months. Conclusions: Desensitization protocols provide a practical solution for managing hypersensitivity, ensuring patients complete systemic therapy without compromising efficacy. This study demonstrates survival outcomes comparable to global trials, such as GOG-0213, while maintaining a manageable safety profile. These findings highlight the potential of desensitization to enhance outcomes in metastatic cervical cancer care. Future prospective studies with larger cohorts are warranted to validate and refine these strategies. Patient characteristics and outcomes. Variable N (%) Total Patients 22 (100) Median PFS (weeks) 44 Progression Rate 42.9% Adverse Events (Grade 1–2) - Nausea 90.5% - Anemia 52.3% Desensitization Success Rate 100%