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年度重大进展:宫颈癌。

Top advances of the year: Cervical cancer.

机构信息

Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Virginia School of Medicine, Charlottesville, Virginia, USA.

出版信息

Cancer. 2023 Mar 1;129(5):657-663. doi: 10.1002/cncr.34617. Epub 2023 Jan 7.

Abstract

Cervical cancer continues to affect women in the United States and throughout the world despite an effective vaccine against human papillomavirus and cancer screening programs. For the women who develop cervical cancer, surgery, radiation, and chemotherapy have been the mainstays of treatment for years. Recently, novel therapeutics have been developed that offer new treatment opportunities for women living with advanced and/or recurrent disease. Immunotherapy has become an important tool against cervical cancer with the approval of pembrolizumab in the second line for advanced or recurrent disease. Checkpoint inhibitors have recently been approved in the front line for advanced and/or recurrent disease in combination with chemotherapy, and they are being studied in the front line in combination with chemoradiation. Antibody-drug conjugates-specifically tisotumab vedotin (TV)-also have recently received Food and Drug Administration (FDA) approval, and TV is currently being studied in combination with checkpoint inhibitors and with carboplatin. Tumor-infiltrating lymphocytes have been studied in early-phase trials and have shown promise in small patient series. Despite these new therapies, there continue to be racial, ethnic, and socioeconomic inequities with respect to access to care, access to and participation in clinical trials, and survival in the United States as well as globally. New FDA guidance requires researchers to work to reduce disparities by including women of more diverse backgrounds in clinical trials. Finally, as progress continues to be made in the treatment of established disease, prevention through vaccination and screening remains paramount. PLAIN LANGUAGE SUMMARY: The treatment of cervical cancer remains a significant problem in the United States and especially worldwide. Although early cases can be cured, cervical cancer that has spread remains difficult to treat. The past few years have seen significant advances in new therapies and combinations of therapies for women with advanced or recurrent disease. Although this is excellent news for these women, cervical cancer is a preventable disease through screening with Papanicolaou smears and vaccination with the human papillomavirus vaccine. By improving access to and acceptance of screening and vaccination, we can eradicate cervical cancer in the United States and the world.

摘要

尽管有针对人乳头瘤病毒的有效疫苗和癌症筛查计划,但宫颈癌仍在美国乃至全球范围内影响着女性。对于那些患上宫颈癌的女性来说,多年来,手术、放疗和化疗一直是主要的治疗方法。最近,新的治疗方法已经开发出来,为患有晚期和/或复发性疾病的女性提供了新的治疗机会。免疫疗法已成为宫颈癌的重要治疗手段,帕博利珠单抗已被批准用于晚期或复发性疾病的二线治疗。检查点抑制剂最近已被批准用于晚期和/或复发性疾病的一线治疗,与化疗联合使用,并且正在联合化疗和放化疗的一线治疗中进行研究。抗体药物偶联物——特别是替妥珠单抗 Vedotin(TV)——最近也获得了美国食品和药物管理局(FDA)的批准,TV 目前正在与检查点抑制剂联合使用,并与卡铂联合使用。肿瘤浸润淋巴细胞已在早期临床试验中进行了研究,并在小患者系列中显示出了前景。尽管有了这些新的治疗方法,但在美国乃至全球,在获得治疗、参与临床试验以及生存方面,仍然存在着种族、民族和社会经济方面的不平等。新的 FDA 指导要求研究人员通过在临床试验中纳入更多不同背景的女性来努力减少差异。最后,随着在治疗既定疾病方面取得进展,通过疫苗接种和筛查来预防仍然至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c0f2/10107116/8bb9bcd10c12/CNCR-129-657-g002.jpg

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