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Uterine Cervical Cancer pp 191–214Cite as

Management of Recurrent Uterine Cervical Cancer

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Abstract

Although primary and secondary prevention strategies are widely applied, a significant number of women will develop recurrent or metastatic cervical cancer. In addition, 5% of newly diagnosed cervical cancers of the uterus are already metastatic. The established platinum-based chemotherapy remains the gold standard for advanced stages, but the prognosis still remains dismal. There is an increasing need for the use of new agents taking into consideration that since bevacizumab was approved in first-line treatment, no further progress in terms of therapeutic options has been achieved. Furthermore, the administration of bevacizumab, due to subsequent patients’ survival prolongation, will ultimately lead to a greater number of women to the point of second or even further line therapy administration.

Besides platinums other chemotherapy agents that have shown efficacy in recurrent or metastatic cervical cancer include vinca alkaloids, taxanes, topoisomerase inhibitors, alkylating agents, and antimetabolites. Clinical trials evaluating the role of anti-EGFR monoclonal antibodies, tyrosine kinase inhibition, mTOR-targeted molecules, and therapeutic vaccines have been conducted indicating that more research needs to be conducted in large-scale trials. Taking into consideration the established association between cervical cancer and HPV infection, there is a trend toward the evaluation of possible benefit with the use of immunomodulatory agents such as anti-CTLA4 and anti-PD-1/PD-L1 which are able of activating the immune system by reversing immune-evading mechanisms.

The existing limitations in the therapeutic armory of metastatic cervical cancer can be overcome through further investigation and encouragement for participation in clinical trials in order to prolong patient’s survival in terms of enhanced quality of life (Fig. 11.1).

Therapeutic landscape of recurrent cervical cancer

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Authors and Affiliations

  1. Department of Medical Oncology, Ioannina University Hospital, Ioannina, Greece

    George Zarkavelis, Alexandra Papadaki, Ioannis Zerdes & Stergios Boussios

  2. Department of Medicine, Ioannina University Medical School, Ioannina, Greece

    Aristides Kefas

  3. Gynaecology Unit, General Hospital “G. Hatzikosta”, Ioannina, Greece

    Konstantina Tatsi

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  1. George Zarkavelis
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  1. The Joan and Sanford I. Weill Medical College/Graduate School of Medical Sciences, The New York Presbyterian Hospital-Weill Cornell Medical Center, and Sandra and Edward Meyer Cancer Center, Cornell University, New York, NY, USA

    Samir A. Farghaly

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Zarkavelis, G., Papadaki, A., Kefas, A., Zerdes, I., Tatsi, K., Boussios, S. (2019). Management of Recurrent Uterine Cervical Cancer. In: Farghaly, S. (eds) Uterine Cervical Cancer. Springer, Cham. https://doi.org/10.1007/978-3-030-02701-8_11

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