Goh Jeffrey Chee-Hong, Lai Chyong-Huey, Domingo Efren Javier, Kim Jae Hoon, Spiteri Carmel, Hsu Danny, Ihm Soo Yeon, Peng Peng
Department of Medical Oncology, Royal Brisbane and Women's Hospital, Herston, Australia.
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou branch, Taoyuan, Taiwan.
Cancer Res Commun. 2025 Aug 1;5(8):1429-1440. doi: 10.1158/2767-9764.CRC-24-0647.
Despite treatment advances for metastatic cervical cancer (mCC), the Asia-Pacific region faces significant barriers in treatment accessibility, availability, and healthcare infrastructure. This study explored the treatment landscape and barriers for mCC in the Asia-Pacific. A descriptive, cross-sectional, web-based study evaluating cervical cancer treatment patterns was conducted among medical, radiation, and gynecologic oncologists and gynecologists in the Chinese mainland (n = 80), Australia, the Philippines, South Korea, and Taiwan (n = 20 each). Eligible respondents were primarily involved in direct patient care (≥60%) and were key treatment deciders with ≥5 years of experience. Among patients with cervical cancer of 160 physicians, 10.9% had metastatic disease, of which 50.3% were aged 41 to 60 years and had Eastern Cooperative Oncology Group scores of 0 to 2 (78.7%). Top treatment modalities included systemic therapy (ST) alone (43.6%) and radiotherapy + ST (33.4%). Top first-line regimens were carboplatin/cisplatin + paclitaxel ± bevacizumab (42.3% and 33.1%, respectively), and the top second-line treatment regimens were carboplatin + paclitaxel + bevacizumab (12.0%) and cisplatin + paclitaxel + bevacizumab (11.5%). PD-L1 testing was more common in South Korea (80.8%) than in the Chinese mainland (48.8%) and Taiwan (26.4%). Treatment drivers included National Comprehensive Cancer Network guidelines (82.7%), disease stage (87.4%), Eastern Cooperative Oncology Group status (83.5%), comorbidities (59.1%), drug efficacy (88.2%), safety (84.3%), and accessibility (66.9%). Treatment challenges included poor prognosis (26.8%), patient affordability (21.3%), and limited treatment option availability (19.7%). In bevacizumab-reimbursed locations, patient tolerability and insufficient medical resources persisted. In conclusion, approximately 11% of cervical cancer cases were metastatic. Treatment preferences were radiotherapy and ST, with funding, cost, accessibility, and availability challenges. Policies supporting reimbursement and accessibility could encourage the adoption of effective alternative therapies.
The findings offer valuable insights about current treatments and the related unmet needs in funding, cost, accessibility, and availability across the Asia-Pacific region. These further highlight areas of importance and the need for implementing reimbursement policies and enhancing accessibility to support the adoption of effective, advanced treatments.
尽管转移性宫颈癌（mCC）的治疗取得了进展，但亚太地区在治疗可及性、可获得性和医疗基础设施方面面临重大障碍。本研究探讨了亚太地区mCC的治疗情况和障碍。在中国内地（n = 80）、澳大利亚、菲律宾、韩国和台湾地区（各n = 20）的医学、放射和妇科肿瘤学家以及妇科医生中开展了一项基于网络的描述性横断面研究，评估宫颈癌的治疗模式。符合条件的受访者主要参与直接患者护理（≥60%），并且是具有≥5年经验的关键治疗决策者。在160名医生诊治的宫颈癌患者中，10.9%患有转移性疾病，其中50.3%年龄在41至60岁之间，东部肿瘤协作组（Eastern Cooperative Oncology Group）评分为0至2（78.7%）。主要治疗方式包括单纯全身治疗（ST，43.6%）和放疗 + ST（33.4%）。一线主要治疗方案是卡铂/顺铂 + 紫杉醇 ± 贝伐单抗（分别为42.3%和33.1%），二线主要治疗方案是卡铂 + 紫杉醇 + 贝伐单抗（12.0%）和顺铂 + 紫杉醇 + 贝伐单抗（11.5%）。程序性死亡受体1配体（PD-L1）检测在韩国（80.8%）比在中国内地（48.8%）和台湾地区（26.4%）更常见。治疗驱动因素包括美国国立综合癌症网络（National Comprehensive Cancer Network）指南（82.7%）、疾病分期（87.4%）、东部肿瘤协作组状态（83.5%）、合并症（59.1%）、药物疗效（88.2%）、安全性（84.3%）和可及性（66.9%）。治疗挑战包括预后不良（26.8%）、患者可承受性（21.3%）和治疗选择有限（19.7%）。在贝伐单抗可报销的地区，患者耐受性和医疗资源不足的问题仍然存在。总之，约11%的宫颈癌病例为转移性。治疗偏好为放疗和ST，存在资金、成本、可及性和可获得性方面的挑战。支持报销和可及性的政策可能会鼓励采用有效的替代疗法。
这些发现为亚太地区当前的治疗情况以及在资金、成本、可及性和可获得性方面相关未满足的需求提供了有价值的见解。这些进一步突出了重要领域以及实施报销政策和提高可及性以支持采用有效、先进治疗方法的必要性。
