Cervical cancer therapy: current, future and anti-angiogensis targeted treatment

Abstract

While the incidence of cervical cancer has declined significantly in the USA, ethnic disparities remain in terms of increased mortality and morbidity. Furthermore, this disease continues to be a significant burden on developing countries, with cervical cancer currently ranked as the second most common cause of cancer-related morbidity and the third most common cause of mortality worldwide. Treatment of cervical cancer has typically been viewed as surgical with possible adjuvant therapy versus initial radiotherapy and platinum-based chemotherapy. Prognosis and therapy for patients with recurrent disease is dependent upon the site of recurrence and ability to pursue curative therapy. This article will review the management of cervical cancer, including studies that have evaluated the treatment of distant metastasis or recurrent disease, as well as discussing the importance of angiogenesis and the use of therapies targeted against this phenomenon.

Treatment of metastatic cervical cancer: Future directions involving targeted agents

“…Analysis of human cervical cancer specimens for VEGF mRNA expression and immunohistochemistry shows that VEGF is markedly up-regulated in human squamous carcinoma cells [20]. Interestingly, VEGF protein expression is higher in cervical adenocarcinoma compared to other histotypes, which may suggest differential role of VEGF among the different subtypes of cervical cancer [21].…”

“…Angiogenesis plays a significant role in tumor progression from a premalignant lesion to an invasive cervical cancer [15,[18][19][20]. Analysis of human cervical cancer specimens for VEGF mRNA expression and immunohistochemistry shows that VEGF is markedly up-regulated in human squamous carcinoma cells [20].…”

Elevated Expression of Thymosin β4, Vascular Endothelial Growth Factor (VEGF), and Hypoxia Inducible Factor (HIF)-1α in Early-Stage Cervical Cancers

“…Angiogenesis and tumor metastasis increase the lethality of cervical cancer and many clinical approaches are aimed at preventing angiogenesis and metastasis [19,20]. Altered angiogenesis is an important phenotype of high-grade cervical lesions and invasive cervical carcinomas.…”

Bevacizumab in the Treatment of Cervical Cancer – Current Evidence and Next Steps

“…In addition, HPV E6 (in a p53 independent manner) and E7 also enhance the induction of HIF-1α, thus increasing VEGF through a second mechanism (see Figure 1). [28][29][30][31] Over the past decade, the relationship between HPV-16-and shown an association with risk of lymph node metastasis, and worse PFS and OS. 36 The differences in outcome observed in these studies may be related to the method used to study MVD.…”