Tri-Weekly Cisplatin Demonstrates Comparable Efficacy With Improved Tolerability in Locally Advanced Cervical Cancer
Clinical Summary:
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Design/Population: The phase 3 TACO trial compared weekly versus tri-weekly cisplatin administered concurrently with radiotherapy in patients with stage IIB to IVA cervical cancer.
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Key Outcomes: Tri-weekly cisplatin achieved noninferior recurrence-free survival compared with weekly cisplatin while significantly reducing grade 3 or higher hematologic toxicities and improving patient-reported quality of life.
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Clinical Relevance: These findings support tri-weekly cisplatin as an effective alternative to weekly dosing for concurrent chemoradiotherapy in locally advanced cervical cancer, offering comparable efficacy with improved tolerability.
Results from the phase 3 TACO trial demonstrated that tri-weekly cisplatin administered with radiotherapy achieved noninferior recurrence-free survival (RFS) with improved tolerability compared with weekly cisplatin in patients with locally advanced cervical cancer.
“The standard treatment for locally advanced cervical cancer is cisplatin-based chemoradiotherapy,” stated Sang-Young Ryu, MD, PhD, Korea Institute of Radiological & Medical Science, Seoul, Korea, and coauthors. “However, the optimal dose and dosing schedule of cisplatin remain debated.”
In this trial, 314 patients with stage IIB to IVA cervical cancer were randomized 1:1 to receive either 40 mg/m² of cisplatin weekly for 6 cycles or 75 mg/m² of tri-weekly every 3 weeks for three cycles, each administered concurrently with radiotherapy. The primary end point was 3-year RFS. Key secondary end points included overall survival (OS), safety, and quality of life.
Chemotherapy delays occurred more frequently in the weekly cisplatin arm than in the tri-weekly arm (P = .008). The 3-year RFS rate was 78.7% with weekly cisplatin and 84.1% with tri-weekly cisplatin, with no significant difference between treatment groups (hazard ratio [HR], 0.71; 95% confidence interval [CI], 0.39 to 1.32; P = .28). Patterns of recurrence were also comparable between the two regimens.
Tri-weekly cisplatin was associated with significantly fewer grade 3 or higher hematologic toxicities than weekly cisplatin (P < .001). Patients receiving tri-weekly treatment also reported significantly better quality-of-life outcomes across multiple domains.
“Tri-weekly cisplatin-based chemoradiotherapy was not statistically superior to a weekly schedule in terms of survival outcomes for patients with locally advanced cervical cancer,” concluded Dr Ryu et al. “These results suggest tri-weekly cisplatin administration as a feasible alternative for chemoradiotherapy in cervical cancer.”
Source:
Ryu SY, Nam BH, Kim MH, et al. A randomized phase III clinical trial of weekly versus tri-weekly cisplatin-based chemoradiotherapy for locally advanced cervical cancer: Results of the TACO (GCIG/KGOG 1027/THAI 2012) study. ESMO Open. Published online: March 10, 2026. doi: 10.1016/j.esmoop.2026.106102
