a Unit of Biomedical Research on Cancer, Instituto de Investigaciones Biomédicas UNAM/Instituto Nacional de Cancerología , Mexico City , Mexico.
b Subdirection of Basic Research, Instituto Nacional de Cancerología , Mexico City , Mexico.
Expert Opin Drug Metab Toxicol. 2019 Aug;15(8):671-682. doi: 10.1080/17425255.2019.1648431. Epub 2019 Jul 31.
: Beyond early stages of cervical cancer (1A, IA, IB IIA,), locally advanced disease (IB, IIA, 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. : This review briefly discusses the achievements in treating cervical cancer. : 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.
: 对于宫颈癌的早期阶段（1A、IA、IB IIA）以外的局部晚期疾病（IB、IIA、IIA2、IIB、IIIA、IIIB、IIIC、IVA）和晚期（转移性、复发性或持续性疾病）患者，需要药物治疗作为放射增敏剂、辅助治疗或姑息性全身化疗。: 这篇综述简要讨论了治疗宫颈癌的成就。: 有两项研究正在进行中，以优化根治性子宫切除术后的治疗。这些研究比较了中危患者的放化疗与放疗，或高危和局部晚期宫颈癌的治疗强度增加（放化疗加辅助化疗与放化疗）。对于晚期疾病，贝伐珠单抗联合顺铂双药治疗仅将中位生存期延长了 3.5 个月。尽管这一增长略优于顺铂拓扑替康联合顺铂（增加 2.9 个月）（相差 0.6 个月），但双药联合贝伐珠单抗被认为是标准治疗。最近，帕博利珠单抗成为晚期疾病的一线治疗进展后的替代药物。除此之外，晚期疾病的 II 期和 III 期试验数量有限，但在增加。HPV E6/E7 癌蛋白是宫颈癌的阿喀琉斯之踵，人们谨慎乐观地认为这些癌蛋白的拮抗剂将得到进一步开发。
