Francoeur Alex A, Monk Bradley J, Tewari Krishnansu S
Department of Obstetrics and Gynecology, University of California, Irvine, Irvine, CA, USA.
Florida Cancer Specialists and Research Institute, West Palm Beach, FL, USA.
Nat Rev Clin Oncol. 2025 Mar;22(3):182-199. doi: 10.1038/s41571-024-00977-w. Epub 2025 Jan 3.
Cervical cancer is preventable with screening and vaccination approaches; however, access to these preventative measures is limited both nationally and globally and thus many women will still develop cervical cancer. Novel treatments and practice-changing research have improved cervical cancer outcomes over the past few decades. In this Review, we discuss clinical trials that have refined or redefined the treatment of cervical cancers across the early stage, locally advanced, persistent, recurrent and/or metastatic disease settings. Advances for patients with early stage disease have been achieved through trials evaluating less extensive and fertility-preserving surgeries, different surgical approaches (open versus minimally invasive), and sentinel versus full pelvic lymph node dissection. We also discuss results from trials testing the use of neoadjuvant, induction and adjuvant chemotherapy as well as immune-checkpoint inhibitors in patients with locally advanced disease. Finally, we review the progress made with systemic chemotherapy and novel therapeutics, including anti-angiogenic agents, immune-checkpoint inhibitors and antibody-drug conjugates, in the setting of metastatic and/or recurrent cervical cancer. The advances highlighted in this manuscript have reduced morbidity and improved overall survival for patients with this challenging-to-treat disease, while also inspiring additional research and trials in the field.
宫颈癌可通过筛查和疫苗接种方法预防；然而，在国内和全球范围内，获得这些预防措施的机会有限，因此仍有许多女性会患上宫颈癌。在过去几十年中，新的治疗方法和改变临床实践的研究改善了宫颈癌的治疗效果。在本综述中，我们讨论了在早期、局部晚期、持续性、复发性和/或转移性疾病背景下完善或重新定义宫颈癌治疗方法的临床试验。通过评估范围较小的保留生育功能手术、不同手术方式（开放手术与微创手术）以及前哨淋巴结清扫与全盆腔淋巴结清扫的试验，早期疾病患者取得了进展。我们还讨论了在局部晚期疾病患者中测试新辅助化疗、诱导化疗和辅助化疗以及免疫检查点抑制剂使用情况的试验结果。最后，我们回顾了在转移性和/或复发性宫颈癌背景下，全身化疗和新型治疗方法（包括抗血管生成药物、免疫检查点抑制剂和抗体药物偶联物）所取得的进展。本综述中强调的进展降低了发病率，提高了这种难以治疗疾病患者的总生存率，同时也激发了该领域更多的研究和试验。
