Pharmacological Treatment of Patients with Metastatic, Recurrent or Persistent Cervical Cancer Not Amenable by Surgery or Radiotherapy: State of Art and Perspectives of Clinical Research

Abstract

Cervical cancer patients with distant or loco-regional recurrences not amenable by surgery or radiotherapy have limited treatment options, and their 5-year overall survival (OS) rates range from 5% to 16%. The purpose of this paper is to assess the results obtained with chemotherapy and biological agents in this clinical setting. Several phase II trials of different cisplatin (CDDP)-based doublets and a phase III randomized trial showing a trend in response rate, progression-free survival, and OS in favor of CDDP + paclitaxel (PTX) compared with other CDDP-based doublets have been reviewed. The factors predictive of response to chemotherapy as well as the benefits and risks of the addition of bevacizumab to CDDP + PTX have been analyzed. The FDA has recently approved pembrolizumab for patients with recurrent or metastatic cervical cancer in progression on or after chemotherapy whose tumors were PD-L1 positive. Interesting perspectives of clinical research are represented by the use of immune checkpoint inhibitors alone or in addition to chemotherapy, whereas PARP inhibitors and PI3K inhibitors are still at the basic research phase, but promising.

The Emerging Role of Thymopoietin-Antisense RNA 1 as Long Noncoding RNA in the Pathogenesis of Human Cancers

“…Furthermore, the inhibition of mi-143-3P elevated the expression of zinc finger E-box-binding homeobox 1 (ZEB1). Therefore, the upregulated expression of ZEB1 enhanced cell proliferation, migration, and invasion both in vitro and in vivo (Gang et al, 2020). Yang et al (2019a) validated that TMPO-AS1 could bind with miR-577.…”

“…Currently, cervical cancer is the second leading threat to women's health, with *500,000 new cases diagnosed and over 300,000 related deaths occurring annually worldwide (Rob et al, 2010). The 5-year survival rate at an early stage is 88-97%, thus the improvement of early detection efficiency is highly beneficial for patient survival (Gadducci and Cosio, 2020). A growing pool of evidence indicates that lncRNAs are involved in the initiation and promotion of cervical cancer development (Tornesello et al, 2020).…”

“…Overexpressed TMPO-AS1 promotes the malignant behaviors of cervical cancer cells, such as proliferation, migration, and invasion (Yang et al, 2019a;Gang et al, 2020). Gang et al (2020) showed that TMPO-AS1 could function as a sponge targeting miR-143-3p and subsequently inactivate miRNA regulation. Furthermore, the inhibition of mi-143-3P elevated the expression of zinc finger E-box-binding homeobox 1 (ZEB1).…”

Novel Role of IMPA2 in AIFM2-Mediated Apoptosis of Cervical Cancer by Targeting p53

“…Radiotherapy and chemotherapy are still the two main treatments for cervical cancer. However, the prognosis of locally advanced cervical cancer remains poor, and the treatment still results in substantial morbidity owing to resistance of chemotherapy drugs (3,4). Therefore, alternative therapeutic strategies are needed.…”

The Potential Oncogenic and MLN4924-Resistant Effects of CSN5 on Cervical Cancer Cells

“…Approximately 20% of patients may recur despite the combined surgery, chemotherapy and radiotherapy [4]. At present, the combination of platinum, paclitaxel and bevacizumab is suggested to be the rst choice of metastatic cervical cancer [5][6][7], but the prognosis remains poor in general [8]. It is a pressing need to discover potential therapeutic and diagnostic biomarkers to improve survival in women with cervical cancers.…”