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Novel Therapeutics for Recurrent Cervical Cancer: Moving Towards Personalized Therapy

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Abstract

While screening programs and HPV vaccination have decreased the incidence of cervical cancer, still over 13,000 cases occur in the USA annually. Early-stage cervical cancer has an excellent long-term prognosis, with 5-year survival for localized disease being > 90%. Survival decreases markedly for both locally advanced and metastatic disease, and both are associated with a higher risk of recurrence. Few effective treatment options exist for persistent, recurrent, or metastatic cervical cancer. In 2014, the anti-VEGF antibody bevacizumab was approved in combination with chemotherapy based on the results of the Phase III GOG-240 study. As the majority of cervical cancers have a viral etiology, which impairs the immune system, immunotherapy using checkpoint inhibitors and other agents, appears to be a promising approach. In June 2018, the US FDA approved the anti-PD1 antibody pembrolizumab for recurrent or metastatic cervical cancer with PD-L1 expression that progressed after one or more lines of chemotherapy. Another anti-PD1 antibody, cemiplimab also shows potential in this setting, either as monotherapy or combined with radiotherapy, and it is currently being evaluated in a Phase III trial. Additional checkpoint inhibitors including nivolumab, durvalumab, atezolizumab, and camrelizumab are in different stages of clinical development for the disease. Finally, an additional targeted approach being pursued involves PARP inhibitors (rucaparib and olaparib are both in Phase II) based on earlier study results.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL, USA

    Alexander C. Cohen

  2. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, O’Neal Comprehensive Cancer Center, University of Alabama at Birmingham, 1700 6th Avenue South, Room 10250, Birmingham, AL, 35249-7333, USA

    Brandon M. Roane & Charles A. Leath III

Authors
  1. Alexander C. Cohen
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  2. Brandon M. Roane
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  3. Charles A. Leath III
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Corresponding author

Correspondence to Charles A. Leath III.

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Funding

No external funding was used in the preparation of this manuscript. CAL was supported in part by the UG1 CA23330 and P50 CA098252.

Conflict of interest

Alexander C. Cohen, Brandon M. Roane, and Charles A. Leath, III declare that they have no conflicts of interest that might be relevant to the contents of this manuscript.

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Cohen, A.C., Roane, B.M. & Leath, C.A. Novel Therapeutics for Recurrent Cervical Cancer: Moving Towards Personalized Therapy. Drugs 80, 217–227 (2020). https://doi.org/10.1007/s40265-019-01249-z

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