Targeted therapies in gynaecological cancers

Abstract

The treatment of cancer has changed dramatically over the last decade, driven by increased understanding of the cancer genome, immune landscape, molecular alterations and aberrant pathways that drive cancer progression. Advances in molecular biology have led to the development of targeted agents, including monoclonal antibodies, small molecules and check‐point inhibitors. Unlike chemotherapy, which inhibits DNA replication and mitosis, these agents target cancer signalling pathways, stroma, immune microenvironment and vasculature in tumour tissues. In gynaecological cancer, drugs targeting defective DNA repair, such as PARP inhibitors, have been approved for advanced ovarian cancer, and drugs targeting angiogenesis have been used in the treatment of advanced or recurrent ovarian and cervical cancers. Immune check‐point inhibitors such as anti‐PD‐1/PD‐L1 antibodies have proved successful for mismatch repair‐deficient endometrial cancers and HPV‐targeted therapies are under development for HPV‐related malignancies. In this era of precision medicine, improved understanding of cancer biology and genomics needs to be utilised to develop predictive biomarkers for these targeted therapies to maximise patient benefit.

Genes, pathways and vulvar carcinoma - New insights from next-generation sequencing studies

“…The prophylactic HPV vaccine Gardasil-9 is in phase IV trial of preventing progression and "recurrence" of vulvar (and anal) HSIL [34]. In addition, combining therapeutic HPV vaccines with the immune check-point inhibitors, such as anti-PD-1/PD-L1 antibodies, or with targeted therapies, such as PARP inhibitors, was shown to be a promising approach in the treatment of patients with HPV-dependent tumors [35][36][37].…”

Targeted Gene Delivery Therapies for Cervical Cancer

“…Advances in molecular biology have led to the development of new targeted agents, including drugs targeting defective DNA repair, such as PARP inhibitors; drugs targeting angiogenesis; and immune check-point inhibitors such as anti-PD-1/PD-L1 antibodies [10]. Several clinical trials are currently underway, focusing on these therapeutic strategies for the treatment of cervical cancer.…”

Prognostic Implications of Immune-Related Genes’ (IRGs) Signature Models in Cervical Cancer and Endometrial Cancer

“…Traditionally, a patient may be treated with surgical removal of the lesions and adjacent lymph nodes in combination with cycles of radiotherapy and chemotherapy (Cosper et al, 2019). Recently, immunotherapy has been increasingly used in clinical settings (Crusz and Miller, 2020) and has now becomes one of the important areas of cancer research.…”