Everyone knows if you get called out while daydreaming during gyn onc tumor board, the answer is carbo/taxol. This South Korean single-arm phase 2 trial assessed adjuvant cisplatin + docetaxel (easier to administer with less neuropathy) as a juicy twist for 62 women with resected high-risk endometrial cancer. High-risk here was stage I+ with at least 2 risk factors (grade 3, positive lymphovascular invasion, more than half of myometrium invasion), stage IB+ with clear cell or serous histology, stage II+ post-simple hysterectomy and any stage III. Chemotherapy was followed by conventionally-fractionated whole pelvis radiation. The prespecified goal was to compare disease-free survival at 5 years to that achieved across a similar population with pelvic radiation alone (63%). In the end, disease-free survival at 5 years was 79% and overall survival an impressive 96%.The authors note survival outcomes compare favorably to PORTEC-3 but such a leap to compare across these trials is a big one. Nonetheless, cisplatin+docetaxel appears a commonsense and possibly better-tolerated alternative to carboplatin+paclitaxel and may be worth exploring in future systemic therapy trials, even if it eventually ruins our go-to answer. | Kang, Int J Radiat Oncol Biol Phys 2024
