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转移性/持续性和复发性宫颈癌的靶向治疗选择。

Targeted treatment options for the management of metastatic/persistent and recurrent cervical cancer.

机构信息

Department of Obstetrics, Gynecology and Reproductive Sciences, Division of Gynecologic Oncology, Smilow Cancer Hospital, Yale University, School of Medicine, New Haven, CT, USA.

出版信息

Expert Rev Anticancer Ther. 2022 Jun;22(6):633-645. doi: 10.1080/14737140.2022.2075348. Epub 2022 May 23.

Abstract

INTRODUCTION

Cervical cancer is the overall fourth most common malignancy and the fourth most common cause of cancer-related deaths worldwide. Despite vaccination and screening programs, many women continue to present with advanced stage cervical cancer, wherein the treatment options have been limited.

AREAS COVERED

In this review, immunotherapy and the potential targeted therapies that have demonstrated promise in the treatment of persistent, recurrent, and metastatic cervical cancer are discussed.

EXPERT OPINION

Our global goal in the gynecologic oncology community is to eliminate cervical cancer, by increasing the uptake of preventive vaccination and screening programs. For unfortunate patients who present with metastatic, persistent, and recurrent cervical cancer, pembrolizumab with chemotherapy, with or without bevacizumab is the new first-line therapy for PD-L1 positive patients. For this patient population as a second-line therapy, tisotumab vedotin (i.e. ADC) has shown significant efficacy in phase II trials, leading to the US Food and Drug Administration approval. Combination regimens inclusive of immune checkpoint inhibitors, DNA damage repair inhibitors, and antibody drug conjugates are potential breakthrough treatment strategies and are currently being investigated.

摘要

简介

宫颈癌是全球第四大常见恶性肿瘤,也是全球癌症相关死亡的第四大常见原因。尽管有疫苗接种和筛查计划,但许多女性仍患有晚期宫颈癌,其治疗选择有限。

涵盖领域

在这篇综述中,讨论了免疫疗法和在治疗持续性、复发性和转移性宫颈癌方面显示出前景的潜在靶向治疗方法。

专家意见

我们妇科肿瘤学界的全球目标是通过增加预防疫苗接种和筛查计划的普及来消除宫颈癌。对于不幸患有转移性、持续性和复发性宫颈癌的患者,对于 PD-L1 阳性患者,pembrolizumab 联合化疗,无论是否联合贝伐珠单抗,都是新的一线治疗药物。对于这一患者群体,替妥珠单抗 Vedotin(ADC)在 II 期试验中显示出显著疗效,从而获得美国食品和药物管理局的批准。包括免疫检查点抑制剂、DNA 损伤修复抑制剂和抗体药物偶联物的联合治疗方案是潜在的突破性治疗策略,目前正在研究中。

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