Pharmacodynamics of current and emerging treatments for cervical cancer

Alfonso Duenas-Gonzalez, Aurora Gonzalez-Fierro

    Research output: Contribution to journalArticle

    2 Scopus citations

    Abstract

    Introduction: Beyond early stages of cervical cancer (1A1, IA2, IB1, IIA1,), locally advanced disease (IB2, IIA2, IIA2, IIB, IIIA, IIIB, IIIC, IVA) and advanced (metastatic, recurrent or persistent disease) patients require drug therapy either as radiosensitizer, adjuvant or as palliative systemic chemotherapy. Areas covered: This review briefly discusses the achievements in treating cervical cancer. Expert opinion: Two studies are ongoing to optimize treatment after radical hysterectomy. These studies compare chemoradiation versus radiation in intermediate-risk patients or increasing treatment intensity (chemoradiation plus adjuvant chemotherapy versus chemoradiation) for high-risk and locally advanced cervical cancer. Concerning advanced disease, bevacizumab increased median survival for only 3.5 months when added to a cisplatin-doublet. Although this increase is slightly superior to the 2.9 months gained with cisplatin topotecan versus cisplatin, (0.6 months of difference), the doublet plus bevacizumab is considered the standard of care. Recently, pembrolizumab became an alternative for advanced disease that progresses to first-line treatment. Beyond that, the number of phase II and phase III trials in advanced disease is limited but on the increase. HPV E6/E7 oncoproteins are the Achilles Heel of cervical cancer, and there is cautious optimism that antagonists of these oncoproteins will be further developed.

    Original languageEnglish (US)
    Pages (from-to)671-682
    Number of pages12
    JournalExpert Opinion on Drug Metabolism and Toxicology
    Volume15
    Issue number8
    DOIs
    StatePublished - Aug 3 2019

    Keywords

    • Advanced cervical cancer
    • E6/E7 oncogenes
    • HPV
    • checkpoint inhibitors
    • chemoradiation
    • chemotherapy
    • locally advanced cervical cancer
    • novel cytotoxics
    • radiosensitizers
    • tyrosine kinase inhibitors

    ASJC Scopus subject areas

    • Toxicology
    • Pharmacology

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