A study which trialled whether cervical cancer patients benefitted from a short course of chemotherapy before standard treatment has achieved the biggest improvement in survival and relapse for more than 20 years.
The results have been hailed as a "remarkable" breakthrough for a cancer that is diagnosed in around 350 women a year in Scotland.
Researchers from University College London (UCL) investigated what happened when patients were given a short course of induction chemotherapy (IC) - using a drug to destroy as many cancer cells as possible - prior to the standard treatment of chemo-radiation (CRT).
The preliminary findings, presented at the European Society for Medical Oncology congress, found an overall reduction in death and disease.
READ MORE: Thousands wrongly excluded from cervical screening to be invited for check ups
After five years, 80% of those who received IC plus CRT - a combination of chemotherapy and radiotherapy - were alive, and 73% had not seen their cancer return or spread.
This compared to 72% and 64% respectively in the standard treatment group.
Lead investigator, Dr Mary McCormack, of the UCL Cancer Institute and UCL Hospitals NHS Foundation Trust, said: "Our trial shows that this short course of additional chemotherapy delivered immediately before the standard CRT can reduce the risk of the cancer returning or death by 35%.
"This is the biggest improvement in outcome in this disease in over 20 years.
"I'm incredibly proud of all the patients who participated in the trial; their contribution has allowed us to gather the evidence needed to improve treatment of cervical cancer patients everywhere.
"We couldn't have done this without the generous support of Cancer Research UK."
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Around half of cervical cancer cases are found in women in their 30s and 40s, although all females aged 25 to 64 in Scotland are invited for routine smear tests.
In 2021, 32% of cases were detected at stages III and IV - compared to 25% in 2019 - with the pause in screening during the pandemic blamed for the increase.
Since 1999, CRT has been the standard treatment, but despite improvements in radiation therapy techniques cancer returns in up to 30% of cases.
Five-year survival rate for cervical cancer in the UK is around 70%.
The 10-year Interlace trial recruited 500 patients from hospitals in the UK, Mexico, India, Italy and Brazil.
They had all been diagnosed with cervical cancer which was large enough to be seen without a microscope but had not spread to other parts of the body.
Because the drugs required for IC - carboplatin and paclitaxel - are cheap, accessible and already approved for use in patients, the researchers say they could be incorporated into standard of care treatment relatively quickly.
Professor Jonathan Ledermann, senior author of the results from UCL Cancer Institute, said the findings were "an important advance in treatment".
READ MORE: Why are cancer rates on the rise among adults under-50?
Dr Iain Foulkes, executive director of research and innovation at Cancer Research UK, said: "Timing is everything when you're treating cancer. The simple act of adding induction chemotherapy to the start of chemoradiation treatment for cervical cancer has delivered remarkable results in this trial.
"A growing body of evidence is showing the value of additional rounds of chemotherapy before other treatments like surgery and radiotherapy in several other cancers.
"Not only can it reduce the chances of cancer coming back, it can be delivered quickly using drugs already available worldwide.
"We're excited for the improvements this trial could bring to cervical cancer treatment and hope short courses of induction chemotherapy will be rapidly adopted in the clinic."
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