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宫颈癌的进展:当前见解与未来方向

Advances in cervical cancer: current insights and future directions.

作者信息

Xu Miaochun, Cao Canhui, Wu Peng, Huang Xiaoyuan, Ma Ding

机构信息

Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, P. R. China.

National Clinical Research Center for Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, P. R. China.

出版信息

Cancer Commun (Lond). 2025 Feb;45(2):77-109. doi: 10.1002/cac2.12629. Epub 2024 Nov 29.

Abstract

In alignment with the World Health Organization's strategy to eliminate cervical cancer, substantial progress has been made in the treatment of this malignancy. Cervical cancer, largely driven by human papillomavirus (HPV) infection, is considered preventable and manageable because of its well-established etiology. Advancements in precision screening technologies, such as DNA methylation triage, HPV integration detection, liquid biopsies, and artificial intelligence-assisted diagnostics, have augmented traditional screening methods such as HPV nucleic acid testing and cytology. Therapeutic strategies aimed at eradicating HPV and reversing precancerous lesions have been refined as pivotal measures for disease prevention. The controversy surrounding surgery for early-stage cervical cancer revolves around identifying optimal candidates for minimally invasive and conservative procedures without compromising oncological outcomes. Recent clinical trials have yielded promising results for the development of systemic therapies for advanced cervical cancer. Immunotherapies, such as immune checkpoint inhibitors (ICIs), antibody-drug conjugates (ADCs), and targeted therapy have demonstrated significant effectiveness, marking a substantial advancement in cervical cancer management. Various combination therapies have been validated, and ongoing trials aim to enhance outcomes through the development of novel drugs and optimized combination regimens. The prospect of eradicating cervical cancer as the first malignancy to be eliminated is now within reach. In this review, we provide a comprehensive overview of the latest scientific insights, with a particular focus on precision managements for various stages of cervical disease, and explore future research directions in cervical cancer.

摘要

根据世界卫生组织消除宫颈癌的战略,在这种恶性肿瘤的治疗方面已经取得了重大进展。宫颈癌主要由人乳头瘤病毒(HPV)感染驱动,由于其病因明确,被认为是可预防和可控制的。DNA甲基化分类、HPV整合检测、液体活检和人工智能辅助诊断等精准筛查技术的进步,增强了HPV核酸检测和细胞学等传统筛查方法。旨在根除HPV和逆转癌前病变的治疗策略已被完善为疾病预防的关键措施。早期宫颈癌手术的争议围绕着在不影响肿瘤学结果的情况下确定微创和保守手术的最佳候选人。最近的临床试验为晚期宫颈癌全身治疗的发展带来了有希望的结果。免疫疗法,如免疫检查点抑制剂(ICIs)、抗体药物偶联物(ADCs)和靶向治疗,已显示出显著疗效,标志着宫颈癌管理取得了重大进展。各种联合疗法已经得到验证,正在进行的试验旨在通过开发新药和优化联合方案来提高疗效。消除宫颈癌作为第一种将被消除的恶性肿瘤的前景现在已经在望。在这篇综述中,我们全面概述了最新的科学见解,特别关注宫颈疾病各个阶段的精准管理,并探讨宫颈癌未来的研究方向。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c437/11833674/ed23c0d634a0/CAC2-45-77-g001.jpg

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