Okpalanwaka Izuchukwu F, Anazodo Francis I, Chike-Aliozor Zimuzor L, Ekweozor Chika, Ochie Kossy M, Oboh Onyeka F, Okonkwo Faustina C, Njoku Munachiso F
Department of Immunotherapeutics and Biotechnology, Texas Tech University Health Sciences Center, Abilene, USA.
Department of Pharmaceutical and Medicinal Chemistry, University of Nigeria, Nsukka, NGA.
Cureus. 2024 Sep 10;16(9):e69136. doi: 10.7759/cureus.69136. eCollection 2024 Sep.
Cervical cancer remains a leading cause of cancer-related mortality in women in low and middle-income countries despite efforts to improve prevention and standard-of-care interventions. Sub-Saharan Africa (SSA) leads the numbers for global cervical cancer incidence and mortality, with the majority of the incidence diagnosed in the late stage of the malignancy. Although the global cervical cancer death rate has been on the decline for the last two decades owing to advancements in screening and treatment options, the mortality rate in SSA has not declined very much. Chemotherapy has been the treatment of choice for cervical cancer in SSA without meeting the expected survival outcomes in these patients, with the majority having advanced diseases at diagnosis. Immune checkpoint inhibitors have recently shown clinical promise in improving the survival of patients with advanced cervical cancer and have been integrated into the treatment guidelines in most high-income countries, which have helped further reduce the mortality rate of cervical cancer. However, many SSA countries are yet to fully benefit from using immune checkpoint inhibitors in cervical cancer. In this review, we discuss the challenges hindering the effective use of immune checkpoint inhibitors for advanced cervical cancer in Africa and possible solutions.
尽管已努力改善预防措施和标准治疗干预措施,但宫颈癌仍是低收入和中等收入国家女性癌症相关死亡的主要原因。撒哈拉以南非洲地区(SSA)的全球宫颈癌发病率和死亡率最高,大多数病例在恶性肿瘤晚期才被诊断出来。尽管在过去二十年中,由于筛查和治疗手段的进步,全球宫颈癌死亡率一直在下降,但SSA地区的死亡率并没有太大下降。化疗一直是SSA地区宫颈癌的首选治疗方法,但这些患者并未达到预期的生存结果,大多数患者在诊断时已处于晚期。免疫检查点抑制剂最近在改善晚期宫颈癌患者的生存率方面显示出临床前景,并已被纳入大多数高收入国家的治疗指南,这有助于进一步降低宫颈癌的死亡率。然而,许多SSA国家尚未充分从在宫颈癌中使用免疫检查点抑制剂中受益。在这篇综述中,我们讨论了阻碍非洲有效使用免疫检查点抑制剂治疗晚期宫颈癌的挑战以及可能的解决方案。