Cancers of the cervix are diagnosed in more than 12,000 women in the United States every year. Worldwide, the annual tally of new cases reaches more than half a million.
The biggest advance against the disease in recent years has come in the area of prevention. Vaccination against the human papilloma virus (HPV) – two strains of which are responsible for 70 percent of cervical cancers – can sharply reduce the risk of developing pre-cancerous abnormalities in the cervix, as well as the vulva and vagina. Health authorities recommend vaccination for girls and young women age 9-26 and boys age 9-21.
Standard treatments for cervical cancer vary depending on how extensive the disease is when diagnosed. At Dana-Farber’s Susan F. Smith Center for Women’s Cancers, patients with Stage I disease, in which tumors are small and confined to the cervix, are treated with surgery and, often, radiation therapy. Larger cancers that have invaded surrounding tissue are treated with radiation and platinum-based chemotherapy – medicines that have been shown to lengthen patients’ survival. Metastatic cancers are generally treated with combinations of chemotherapy and other drugs, including anti-angiogenesis agents that cut off a tumor’s blood supply.
For women with persistent or recurrent cervical cancer, researchers are exploring several new approaches. One, involving targeted therapies, is being tested in a phase 2 clinical trial led by Ursula Matulonis, MD, medical director of Gynecologic Oncology at the Susan f. Smith Center. The trial explores the safety and effectiveness of two potential drugs that target mutations in key genetic pathways in cervical cancer. The trial is based on previous work at Dana-Farber showing that such agents can be active against cervical cancer cells.
Another new approach involves one of the hottest areas of cancer research today: immunotherapy. These agents, which have been effective in treating some patients with melanoma, lung cancer, and other cancers are designed to unleash patients’ own immune system to fight cervical cancer. Ongoing trials of immunotherapy drugs for cervical cancer include include:
- A phase 2 trial of the drug nivolumab for recurrent cervical cancer;
- A phase 2 trial of the drug ipilimumab for recurrent or metastatic cervical cancer;
- A phase 1 study of chemotherapy and radiation therapy followed by ipilimumab for patients with locally advanced cervical cancer.