Top advances of the year: Cervical cancer

Abstract

Cervical cancer continues to affect women in the United States and throughout the world despite an effective vaccine against human papillomavirus and cancer screening programs. For the women who develop cervical cancer, surgery, radiation, and chemotherapy have been the mainstays of treatment for years. Recently, novel therapeutics have been developed that offer new treatment opportunities for women living with advanced and/or recurrent disease. Immunotherapy has become an important tool against cervical cancer with the approval of pembrolizumab in the second line for advanced or recurrent disease. Checkpoint inhibitors have recently been approved in the front line for advanced and/or recurrent disease in combination with chemotherapy, and they are being studied in the front line in combination with chemoradiation. Antibody–drug conjugates—specifically tisotumab vedotin (TV)—also have recently received Food and Drug Administration (FDA) approval, and TV is currently being studied in combination with checkpoint inhibitors and with carboplatin. Tumor‐infiltrating lymphocytes have been studied in early‐phase trials and have shown promise in small patient series. Despite these new therapies, there continue to be racial, ethnic, and socioeconomic inequities with respect to access to care, access to and participation in clinical trials, and survival in the United States as well as globally. New FDA guidance requires researchers to work to reduce disparities by including women of more diverse backgrounds in clinical trials. Finally, as progress continues to be made in the treatment of established disease, prevention through vaccination and screening remains paramount. Plain language summary The treatment of cervical cancer remains a significant problem in the United States and especially worldwide. Although early cases can be cured, cervical cancer that has spread remains difficult to treat. The past few years have seen significant advances in new therapies and combinations of therapies for women with advanced or recurrent disease. Although this is excellent news for these women, cervical cancer is a preventable disease through screening with Papanicolaou smears and vaccination with the human papillomavirus vaccine. By improving access to and acceptance of screening and vaccination, we can eradicate cervical cancer in the United States and the world.

Management of Recurrent or Metastatic Cervical Cancer

“…According to Dr. Abu-Rustum, it is important to note that although chemotherapy can be applied more broadly and used repeatedly, reapplication of definitive RT to the same field is frequently not possible or is unsuccessful. 1 Therefore, surgery is often the best treatment option for these patients.…”

HLA-class II restricted TCR targeting human papillomavirus type 18 E7 induces solid tumor remission in mice

“…Immunotherapy, which utilizes the patient’s immune system to recognize and attack cancer cells, has emerged as a rapidly advancing technology in cancer treatment over the past decades. Immune checkpoint inhibitors (ICIs), which block the immunosuppressive CTLA-4 or PD1 signal pathway of T cells, have been approved and widely used for various types of cancers 4 , including cervical cancer 5 . While some patients experience remarkable remissions, the overall response rate (ORR) of anti-PD1 monotherapy for PDL1-positive cervical cancer is only 14.3% 5 .…”

Disparities in cervical cancer screening in the United States

“…The mortality rates for women from these populations are significantly higher than the population rates." 1…”

“…Women diagnosed with cervical cancer disproportionately are Black and Hispanic and come from backgrounds of low socioeconomic status. The mortality rates for women from these populations are significantly higher than the population rates.” 1 …”