Changing paradigms in the systemic treatment of advanced cervical cancer

Abstract

Despite availability of primary and secondary prevention measures, cervical cancer persists as one of the most common cancers among women around the world. While early stage disease can be cured with radical and even fertility-sparing surgery, patients with metastatic and recurrent cervical cancer have poor prognosis with historically limited treatment options and incurable disease. Significant advances in cervical cancer treatment have emerged as the result clinical trials seeking to determine the best therapy to prolong overall and progression-free survival. Most recently, trials involving angiogenesis blockade in addition to standard chemotherapy have demonstrated improved overall and progression free survival. This review serves to highlight pivotal trials in chemotherapy development for advanced, metastatic and recurrent cervical cancer including the paradigm-shifting work demonstrating increased overall survival with angiogenesis blockade.

Systematic Review and Network Meta-Analysis of Bevacizumab Plus First-Line Topotecan-Paclitaxel or Cisplatin-Paclitaxel Versus Non–Bevacizumab-Containing Therapies in Persistent, Recurrent, or Metastatic Cervical Cancer

“…45 To date, bevacizumab is the only antiangiogenesis agent with demonstrated significant activity against advanced and recurrent cervical cancer. 13 Systematic reviews and meta-analyses of RCTs are considered an important component of evidence for informing clinical practice guidelines and standards of care. Network meta-analysis is an extension of meta-analysis and enables comparisons of interventions that have not been compared head-to-head for the same condition.…”

Cervical cancer: what's new?

“…Other agents with anti angiogenic activity that proved useful in the treatment of other malignancies are being investigated for cervical cancer, such as sunitinib, pazopanib, lapatinib and cediranib. 44 The goal of immune therapy in cervical cancer is to modify the patient's immune response leading to the elimination of cancer cells. One approach explores the relationship of this malignancy with the human papilloma virus (HPV).…”

“…The use of bevacizumab led to improved overall response, progression-free time and survival. [44][45][46] There was benefit for patients with recurrent disease in previously irradiated areas. Adverse effects included neutropenia, hypertension (grade 3), gastrointestinal fistula, and thromboembolism.…”

OGT-mediated O-GlcNAcylation on GLDC promotes metastasis in cervical cancer

“…Although the development of early screening and HPV vaccination reduces the mortality rates in recent years [2,3], the prognosis of patients is still dismal, mainly due to the high incidence of invasiveness and metastasis of cervical cancer [4]. Therefore, investigating the molecular alterations that drive metastasis in cervical cancer is valuable to develop diagnostic targets and potential therapies for this disease.…”