What's New in Cervical Cancer Research?

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 (SNLB)

During surgery for cervical cancer, lymph nodes in the pelvis may be removed to check to see if the cancer has 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 has 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, such as lymphedema (swelling) of the legs.

At this time, SLNB is used mainly in stage I cervical cancers smaller than 2 cm. More studies are planned to see if this procedure should become part of the standard treatment.

Immunotherapy

In cancer, the immune system cannot control the fast growth of tumor cells. Recently, new drugs called immune checkpoint inhibitors have been developed that “reset” the immune system. They have been found to be useful in treating a number of types of cancer. Their helpfulness in cervical cancer treatment is just being discovered, and clinical trials are underway to find out more. One immunotherapy drug is currently available to treat advanced cervical cancer, but studies are being done to see if this or other immunotherapy drugs would work better in combination with chemotherapy or possibly in combination with chemoradiation.

HPV vaccines

Vaccines have been developed to prevent infection with some of the high risk HPV types  that are associated with cervical cancer. Currently available vaccines are intended to produce immunity to HPV types that cause about 90% of cervical cancers.

Other vaccines are meant to help women who already have advanced cervical cancer. 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 reaction will kill the cancer cells or stop them from growing. Studies in advanced cervical cancer showed promising results with a vaccine against the E7 protein (ADXS11-001): tumors shrank or disease stabilized. It is also being studied in early-stage cervical cancer to see if it can help decrease the chance of the cancer returning. Other types of vaccines against the E6 or E7 proteins are also being tested.

Targeted therapy

As researchers have learned more about the gene changes in cells that cause cancer, they have been able to develop new drugs that specifically target these changes. These targeted drugs work differently from standard chemotherapy drugs. They often have side effects different from those in chemotherapy.

Bevacizumab is a targeted agent currently used to treat advanced cervical cancer. Other targeted drugs, such as cediranib and nintedanib, that block certain growth factors that help cancer cells grow have shown to be helpful in some early studies of patients with advanced cervical cancer. These drugs continue to be studied.