Multidisciplinary Patient-Based Approach to Challenging Situations with Cervix Cancer

Cervical cancer continues to be a common cancer globally, especially in less developed regions and some underserved areas in the US where advanced stage presentations are common. Recently published clinical trials looked at addition of novel agents to standard chemoradiation. Through this case-based educational activity, our goal is to inform clinicians of recent practice-changing data as well as innovative strategies that can lead to improved outcomes of patients having challenging situations with cervix cancer. 

Using a multi-disciplinary case-based approach, this activity discusses challenging scenarios that are encountered in the management of women with cervix cancer. The moderators polled the panelists prior to the activity regarding their choice of management for these cases. Audience polling using ARS is also performed and compared with experts before detailed discussion of each scenario to allow for increased engagement and interaction. Specific areas of focus include the choice of brachytherapy technique for locally advanced cervix cancer (highlight importance of hybrid brachytherapy), complex situations with vaginal involvement of recurrent cervix cancer +/- previous radiotherapy (highlight vaginal CTV contouring/ 3D printed applicators/re-irradiation) and finally advanced systemic therapy (updates on immunotherapy) with interplay of radiation for oligorecurrent disease (SABR). All of these topics are relevant to radiation oncologists who see and treat women with cervical cancer. The recent positive results of immunotherapy for women with advanced metastatic cervix cancer have brought immunotherapy to the forefront for these patients. At the same time negative results with adjuvant chemotherapy and concurrent and adjuvant immune checkpoint inhibitors in two major phase III randomized trials (OUTBACK and CALLA, respectively) indicate the need for new radiosensitizing agents for definitive treatment of cervix cancer. These issues are discussed during the presentation on systemic therapy so that the radiation oncologist becomes conversant of these recent advances in systemic therapy to help improve patient outcomes. Finally, the role of ablative radiation interplaying with systemic therapy is briefly discussed for oligo-recurrent cervix cancer.

Topics:

  1. Locally Advanced Cervix Cancer - Tandem, Needles, Hybrid- When and How
    Chika Nwachukwu, MD, PhD
  2. Pelvic/Vaginal Recurrence of Cervical Cancer +/- Prior Radiation
    Elizabeth Kidd, MD
  3. Interplay of Radiation with Modern System Therapy in Recurrent/Metastatic Cervix Cancer
    Ramez Eskander, MD
  4. Ablative Radiation Therapy in Oligometastatic Cervix Cancer (OMCC): When, How, Why? 
    Kevin Albuquerque, MD 
  5. Q and A
    Full Panel

This activity is available from April 9, 2024, through 11:59 p.m. Eastern time on April 8, 2026. 

This activity was originally recorded at the 2023 ASTRO Annual Meeting.

Target Audience

The activity is designed to meet the interests of medical oncologists, radiation oncologists, physicists, nurses, radiation therapists, and residents.  

Learning Objectives

Upon completion of this activity, participants should be able to:

  • Identify the best brachytherapy treatment options for asymmetric large primary cervical cancers and choice of hybrid brachytherapy technique.
  • Be familiar with modern image based complex interstitial brachytherapy/3D printed guidance approach for vaginal involvement and re-irradiation for vaginal recurrence of cervix cancer.  
  • Get updates on advances in systemic therapy for cervix cancer and determine the ideal approach for integrating radiation and systemic therapy for recurrent oligometastatic cervix cancer. 
Course summary
Available credit: 
  • 1.00 AMA PRA Category 1 Credit™
    The American Society for Radiation Oncology (ASTRO) is accredited by the Accreditation Council for Continuing Medical Education for physicians. ASTRO designates this for a maximum of 1.00 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
  • 1.00 Certificate of Attendance
    This activity was designated for 1.00 AMA PRA Category 1 Credit™.
Course opens: 
04/09/2024
Course expires: 
04/08/2026
Cost:
$0.00
Rating: 
0
  • Lilie L. Lin, MD, is employed by The University of Texas MD Anderson Cancer Center. Dr. Lin receives grant research funding from NCI, Pfizer, AstraZeneca, and Varian. Dr. Lin receives honoraria from Trevarx.  
  • Chika R. Nwachukwu, MD, PhD, is employed by University of California, San Diego. 
  • Elizabeth A. Kidd, MD, is employed by Stanford University. Dr. Kidd receives research grant funding from the Stanford Women's Cancer Center Grant and the Stanford Clinical Innovation Fund.  
  • Ramez Eskander, MD, is employed by UC San Diego. Dr. Eskander receives honoraria for advisory board participation and consulting from: AstraZeneca, Seagen, GSK, Immunogen, Merck, Myriad, Eisai, Natera, and Daiichi Sankyo. 
  • Kevin V. Albuquerque, MD, is employed by Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center. Dr. Albuquerque receives honoraria and travel expenses from ACR (serves as a volunteer surveyor) and receives compensation from Elsevier Clinical Path (serves as a committee co-chair). 

  

The person(s) above served as the developer(s) of this activity. Additionally, the Education Committee had control over the content of this activity. All relevant relationships have been mitigated.

Disclosure link: 
Committee Disclosures

The American Society for Radiation Oncology (ASTRO) is accredited by the Accreditation Council of Continuing Medical Education to provide continuing education to physicians.

ASTRO is awarded Deemed Status by the American Board of Radiology to provide SA-CME as part of Part II Maintenance of Certification. 

Available Credit

  • 1.00 AMA PRA Category 1 Credit™
    The American Society for Radiation Oncology (ASTRO) is accredited by the Accreditation Council for Continuing Medical Education for physicians. ASTRO designates this for a maximum of 1.00 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
  • 1.00 Certificate of Attendance
    This activity was designated for 1.00 AMA PRA Category 1 Credit™.

Price

Cost:
$0.00
Please login or register to take this course.

Course Fees:
ASTRO members must log in to the ASTRO website to view and receive the member rate.

Nonmember: $149
Member: $99
Member-in-training: $49
Student/Grad Student/PGY: $49
Postdoctoral Fellow: $49
 

Policies:
No refunds, extensions, or substitutions will be made for those participants who, for any reason, have not completed the course by the end of the qualification date. The qualification date for each course is listed in the course catalog on the ASTRO website under availability.

Participants using ASTRO's online courses to satisfy the requirement of a Maintenance of Certification (MOC) program should verify the number, type and availability dates of any course before making a purchase. No refunds, extensions, or substitutions will be made for participants who have purchased courses that do not align with their MOC requirement.

The course and its materials will only be available on the ASTRO website until April 8, 2026, regardless of purchase date. At the expiration of the qualification, participants will no longer have access to the course or its materials. ASTRO reserves the right to remove a course before the end of its qualification period.

Required Hardware/software

One of the two latest versions of Google Chrome, Mozilla Firefox, Internet Explorer or Safari.