New Cervical Cancer Treatment Improves Survival Rates, Clinical Trial Shows

- A phase 3 clinical trial suggests a new standard of care for treating people with advanced cervical cancer.
- The recommendation includes a combination of induction chemotherapy followed by chemoradiotherapy.
- The researchers are interested in how future studies can investigate the use of immunotherapies to further improve survival rates.
- Clinicians are hopeful the new approach will give people with aggressive cervical cancer additional options for treatment, particularly those who face barriers to healthcare.
Cervical cancer affects approximately 11,500Trusted Source people in the United States each year and 660,000Trusted Source people worldwide.
A phase 3 clinical trial recently published in The LancetTrusted Source proposes a new standard of care for people with cervical cancer who aren’t candidates for surgery. The recommendation includes a combination of induction chemotherapy followed by chemoradiotherapy instead of chemoradiotherapy alone.
Compared to participants who received only chemoradiotherapy, those who received both induction chemotherapy and chemoradiotherapy saw an increase from 64% to 72% in their 5-year progression-free survival rates.
The INTERLACE trial included 500 participants from medical centers in Brazil, India, Italy, Mexico, and the United Kingdom, all of whom had locally advanced cervical cancer.
“Prior to this study, doing chemotherapy before chemotherapy and radiation in combination had not really demonstrated benefit,” said Joshua G. Cohen, MD, medical director of the gynecologic cancer program at City of Hope Orange County, CA, told Healthline. Cohen wasn’t involved in the study.
“This was a large trial, an international trial [that] took over 10 years to complete, but certainly a study that gives us another option to offer patients, which is fabulous,” Cohen told Healthline.
A promising development in cervical cancer treatment
The INTERLACE trial reduced the wait time between the initial course of induction chemotherapy and chemoradiotherapy, yielding promising results.
Study co-author and clinical oncologist Mary McCormack, PhD, told Healthline that while this updated approach has the support of many healthcare professionals, including those in the U.S., not everyone is on board with the new standard-of-care recommendation.
“I think some [concerns] lark back to the ’90s, when the older trials were published and demonstrated a detrimental effect of this approach by giving the chemotherapy,” McCormack said.
“There were a number of issues and potential flaws with those studies when they were all generally small studies and they all used different drug combinations and different schedules. They didn’t control for this interval between finishing the treatment, the chemo, and starting the radiation,” she explained.
The INTERLACE trial study was much broader, with participants spanning five different countries. Those who received both induction chemotherapy and chemoradiotherapy received 6 weeks of chemotherapy, with treatments occurring once a week.
Diana Pearre, MD, a gynecologic oncologist at The Roy and Patricia Disney Family Cancer Center at Providence Saint Joseph Medical Center in California, shared she is optimistic about the new treatment pathway. Pearre wasn’t involved in the clinical trial.
“I suspect many will read this study and think that this is a great way to start our patients on something,” she told Healthline.
“As clinicians, we are often made keenly aware of how different insurances, referrals, and other issues prevent our patients from starting radiotherapy on time. With over 70% of gynecologists also administrating chemotherapy, induction chemotherapy seems like something within our realm of control,” Pearre noted.
What’s next for cervical cancer treatment?
The drugs used in the INTERLACE trial are already broadly available, as are many of the quality-of-life treatments. Scalp cooling, for instance, can be used to combat the side effects of induction chemotherapy.
McCormack hopes to see clinicians make changes to improve cervical cancer treatment outcomes. She is also hopeful that ongoing research — like studies into the use of immunotherapies — could hold the key to even better treatment outcomes.
“I think the next step should be to look at incorporating and adding in immunotherapy with this induction treatment, because there’s good scientific rationale why this might work, and it’s an opportune moment to look at that now. And I do believe there are some groups in the US that are planning to do just that,” McCormack said.
Cohen agreed: “We’ve been looking for years in ways we can incorporate immunotherapy into the use of cervical cancer [treatments] because we all believe that cervical cancer should have an immune therapy treatment, given it’s largely driven by a virus, HPV,” he said, noting around 80% to 90% of cervical cancer is driven by HPV.
As with most medical treatments, access to the proposed standard of care and having it covered by health insurance is a key focus for the future.
While HPV vaccination and cancer screening efforts have increased over the decades, cervical cancer poses a higher risk to those in low-income countries and low-income areas.
While vaccination against HPV is vital to ongoing prevention and treatment efforts, Cohen said the findings of the study could lead to more options for those facing barriers to quality healthcare.
“If you’re in a place where you’re having a tough time getting a radiation oncologist to see you, or you’re getting delays in care, it’s a good option to start with chemotherapy,” he said.
“You have 6 weeks, you can get chemotherapy started, then maybe you get plugged in with the radiation oncologist. This is a good option now that we have data that says it works.”
A new phase 3 clinical trial suggests a new standard of care for people with advanced cervical cancer who aren’t a candidate for surgery.
The promising new recommendation involves a combination of induction chemotherapy followed by chemoradiotherapy instead of just chemoradiotherapy by itself.
Experts are optimistic this approach will give people additional treatment options, particularly those with barriers to healthcare.
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Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available.
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- The FDA has approved two new self-screening tests for HPV.
- Patients would be able to access the self-screening test at a physician’s office.
- While these tests can act as a supplement, the pelvic exam may still be necessary in some cases.
The U.S. Food and Drug Administration approved two new self-tests to detect HPV. These new tests would allow people to take their own sample to test for HPV, instead of having a physician perform a pelvic exam to take a sample.
Detecting HPV can help physicians determine if a person is at risk for cervical cancer.
The tests are made by Roche and BD.
HPV is the most common sexually transmitted infection, with more than 42 million cases in the U.S., according to the CDCTrusted Source.
“The introduction of self-screening tests for cervical cancer is a fascinating development,” said Matthew Casavant, MD, OB/GYN and founder of South Lake Obstetrics & Gynecology. “These tests can potentially increase screening rates by reducing the discomfort and anxiety associated with pelvic exams.”
The HPV test can detect signs of the virus in the cervix. These viruses can be precursors to cervical cancer.
To test for HPV, a physician would traditionally take a swab while doing a pelvic exam of a patient. That swab would then be tested for HPV.
With these new tests, patients themselves can use the swab to take a sample. The sample is taken at the physician’s office, similar to how a urine sample might be taken at a medical office.
However, the FDA may soon allow these tests to be conducted at home, according to the Washington Post.
Dr. June Hou is an associate professor of obstetrics and gynecology at Columbia University Vagelos College of Physicians and Surgeons, and also a specialist in treating gynecologic cancers, said that these types of tests may help remove barriers for women to get HPV testing especially if they are approved for at-home use.
“I am excited about these new tests overall,” Hou said. “Cervical cancer is one of the few preventable cancers by ways of vaccination and screening. To receive screening however, women currently will need to carve time out of their day to make an appointment…These new tests will remove some of these barriers that are time consuming,and will broaden access to cervical cancer screening to more women, in a more convenient way.”
Reasons pelvic exams may still be necessary
However, while these new tests may serve as a supplementary tool, they should not completely replace pelvic exams, Casavant noted. Pelvic exams are crucial for detecting other gynecological issues beyond cervical cancer, such as ovarian cysts, endometriosis, and sexually transmitted infections.
Signs of cervical cancer
Symptoms include:
- irregular bleeding
- unusual vaginal discharge
- pelvic pain
- pain during intercourse
“These symptoms often appear in advanced stages, which is why regular screening through Pap smears and HPV tests are critical for early detection,” Casavant stated.
When it comes to preventing cervical cancer, there are several approaches that can be effective. Being proactive is essential, say medical experts.
“Preventing cervical cancer primarily involves regular screening, getting the HPV vaccine, and practicing safe sex to reduce HPV transmission,” said Casavant.
“Treating cervical cancer might include surgical interventions, radiation therapy, and chemotherapy, depending on the stage at diagnosis. Staying informed about your health, attending regular check-ups, and discussing any concerns with your doctor are the best proactive measures.”
Hou said that the most effective way to prevent cervical cancer is still getting vaccinated against HPV.
“HPV vaccines are extremely effective at preventing HPV infection, the precursor to the vast majority of cervical cancer,” Hou said. “While vaccination is typically recommended before age 12, it is also recommended for everyone up to age 26 if they were not already vaccinated. Additionally, cervical cancer screening is very effective at diagnosing pre-cancer cells of the cervix. Removing the pre-cancer cells will prevent cancer.”
The CDC notes people aged 27 to 45 may also get the HPV vaccine if they were not adequately vaccinated when they were younger.
The FDA has approved two new tests that allow women to perform a self-test to detect signs of HPV. These new tests may help cut out some uncomfortable pelvic exams at the gynecologist.
Source: Healthline