What`s new in cervical cancer research and treatment?
New ways to prevent and treat cancer of the cervix are being researched. Some of the promising new developments include the following:
Sentinel lymph node biopsy
During surgery for cervical cancer, lymph nodes in the pelvis may be removed to check for cancer spread. Instead of removing many lymph nodes, a technique called sentinel lymph node biopsy can be used to target just the few lymph nodes most likely to contain cancer. In this technique a blue dye containing a radioactive tracer is injected into the cancer and allowed to drain into lymph nodes. Then, during surgery, the lymph nodes that contain radiation and the blue dye can be identified and removed. These are the lymph nodes most likely to contain cancer if it had spread. If these lymph nodes don’t contain cancer, the other lymph nodes don’t need to be removed. Removing fewer lymph nodes may lower the risk of later problems.
Vaccines have been developed to prevent infection with some of the HPV types associated with cervical cancer. Currently available vaccines are intended to produce immunity to HPV types 16 and 18, so that women who are exposed to these viruses will not develop infections. Vaccines are also being developed to prevent infection with some of the other HPV types that also cause cancer. Long-term studies are being done to see how well these vaccines will reduce the risk of cervical cancer.
Some experimental vaccines are also being studied for women with established HPV infections, to help their immune systems destroy the virus and cure the infection before a cancer develops. Still other vaccines are meant to help women who already have advanced cervical cancer that has recurred or metastasized. These vaccines attempt to produce an immune reaction to the parts of the virus (E6 and E7 proteins) that make the cervical cancer cells grow abnormally. It is hoped that this immunity will kill the cancer cells or stop them from growing.
As researchers have learned more about the gene changes in cells that cause cancer, they have been able to develop newer drugs that specifically target these changes. These targeted drugs work differently from standard chemotherapy drugs. They often have different (and less severe) side effects. These drugs may be used alone or with more traditional chemotherapy.
Pazopanib is a type of targeted therapy drug that blocks the effect of certain growth factors on cancer cells. In studies of patients with advanced cervical cancer, it helped them live longer.
Bevacizumab (Avastin®) is a targeted therapy drug that helps block the formation of new blood vessels. It has been used alone and with chemotherapy to treat advanced cervical cancer. It is also being studied as a part of the treatment for earlier stage disease.
Some research indicates that adding hyperthermia to radiation may help keep the cancer from coming back and help patients live longer. Hyperthermia is a treatment that raises the temperature in the area where the tumor is, most often by using radiofrequency antennae placed around the patient.
Drug treatment of pre-cancers
Standard treatment of cervical pre-cancer (such as cervical intraepithelial neoplasia; CIN) includes cryotherapy, laser treatment, and conization. Recent studies to see if medicines can be used instead have had some promising results.
In one study, patients with CIN2 or CIN3 took a drug called diindolylmethane (DIM) for 12 weeks. Follow-up testing showed improvement - in some women, the CIN went away completely.
In another study, CIN was treated by applying an anti-viral drug called cidofovir to the cervix. In more than half of the treated women, the CIN resolved completely. More studies are needed before this can become a standard treatment.
Another anti-viral drug, imiquimod, has also shown promising results in treating cervical pre-cancers.
Other clinical trials
Many clinical trials are testing new chemotherapy drugs, new ways of giving radiation therapy, and new combinations of surgery and radiation therapy or chemotherapy.
Last Medical Review: 04/11/2013
Last Revised: 01/31/2014