Targeted Drug Therapy for Cervical Cancer

Targeted drug therapy is the use of medicines that target or are directed at proteins on cervical cancer cells that help them grow, spread, or live longer. Targeted drugs work to destroy cancer cells or slow down their growth.  They have different side effects than chemotherapy and some are taken as a pill.

Some targeted therapy drugs, for example, monoclonal antibodies, work in more than one way to control cancer cells and may also be considered immunotherapy because they boost the immune system.

Different types of targeted drug therapy can be used to treat cervical cancer.

Drugs that target blood vessel formation

Vascular endothelial growth factor (VEGF) is a protein that helps tumors form new blood vessels (a process known as angiogenesis) to get nutrients they need to grow. Some targeted drugs called angiogenesis inhibitors stop VEGF from working and block this new blood vessel growth.

Bevacizumab (Avastin^®) is an angiogenesis inhibitor that can be used to treat advanced cervical cancer. It is a monoclonal antibody (a man-made version of a specific immune system protein) that targets VEGF.

This drug is often used with chemo for a time. Then, if the cancer responds, the chemo may be stopped and the bevacizumab given by itself until the cancer starts growing again.

Possible side effects of drugs that target VEGF

The possible side effects of this drug are different from those of chemotherapy drugs. Some of the more common side effects can include:

• High blood pressure
• Feeling tired
• Nausea

Less common but more serious side effects can include:

• Problems with bleeding
• Blood clots
• Wound healing
• Heart failure or a heart attack

Other rare but serious side effects are the formation of an abnormal opening (called a fistula) between the vagina and part of the colon or intestine or the formation of a hole in the bowel.

Antibody-drug conjugates

An antibody-drug conjugate (ADC) is a monoclonal antibody linked to a chemotherapy drug.

Tisotumab vedotin-tftv (Tivdak): This ADC has an antibody that targets tissue-factor (TF) protein on cancer cells. It acts like a homing signal by attaching to the TF protein bringing the chemo directly to the cancer cell. It can be used to treat cervical cancer that has spread (metastasized) to another part of the body or come back after initial treatment (recurred), typically after at least 2 other drug treatments have been tried. This drug is given in a vein (IV).

Possible side effects of tisotumab vedotin-tftv

Common side effects can include feeling tired, nausea, hair loss, vomiting, bleeding, diarrhea, rash, and nerve damage (peripheral neuropathy).

Common lab abnormalities that might be seen with this drug include low red blood cell counts (anemia), low white blood cell counts, and abnormal kidney function.

This drug can have major side effects involving the eyes. People taking this drug can have dry eye, changes in vision, vision loss, or ulceration of the cornea. They should have regular eye exams while on this drug and tell their healthcare team right away if they have any eye symptoms.