Cervical cancer, a new therapy for women who no longer have options – time.news

Cervical cancer could disappear completely thanks to the vaccine against the Papillomavirus or HPV, which is the main culprit, but in Italy the opportunity is still too little exploited. Just like with another very effective weapon: early diagnosis with the Pap test, available since the seventies, to which the HPV-Dna test has been added more recently. Both (like the 12-year-old vaccine) are offered free by our National Health Service because they can detect any changes in the cells of the cervix before they become cancerous. Yet in our country cervical cancer still represents the fifth most frequent cancer in young women under the age of 50, with about 2,400 new diagnoses registered in 2020. Pre-cancerous lesions take many years to transform into cancer – explains Domenica Lorusso, associate professor of Oncological Gynecology at the Catholic University of the Sacred Heart of Rome – and, thanks to the early diagnosis with Pap test and HPV-Dna test, the lesions can be identified and removed in time, with different strategies available today. precancerous even before the neoplasm develops. But only 68% of women diagnosed with cervical cancer alive five years after diagnosis, an unequivocal sign that prevention is not exploited and that even the symptoms are neglected for a long time.

The standard terapie

In fact, if discovered in the early stages, this type of cancer can be treated less invasively and successfully, allowing patients to heal completely. In general, the early stages of the disease (i.e. tumors smaller than 4 centimeters, confined to the cervix) can be treated with surgery alone, which however requires a radical hysterectomy (i.e. the complete removal of the uterus) – explains Lorusso, responsible clinical research of the Gemelli University Hospital Foundation -, while those locally advanced require an integrated approach of concomitant radio and chemotherapy. If the tumor is discovered in a metastatic phase or recurrence after treatment, things get very complicated: after the first line of chemotherapy, in fact, we have no other standard second line therapy. In practice, different solutions are being tested with immunotherapy, but at the moment there is no effective approved cure and the responses to chemotherapy with any drug are less than 10%. phase three, the last one before drug approval, with a new anti-PD-1 monoclonal antibody, cemiplimab, for which approximately 600 patients (average age 51 years) with advanced-stage cervical cancer were enrolled previously underwent chemotherapy.

The new drug

The trial included women with both squamous cell carcinoma and adenocarcinoma who were randomized to receive cemiplimab alone or one of the commonly used chemotherapy treatments of the investigator’s choice (pemetrexed, vinorelbine, topotecan, irinotecan, or gemcitabine). The study was stopped early for the positive result on overall survival: the results show that the new immunotherapy drug improves overall survival and reduces the risk of death compared to chemotherapy. immune checkpoint PD-1, by binding to which it can block tumor cells. Relapsed or metastatic cervical cancer notoriously difficult to treat – concludes Lorusso -. This study, which enrolled patients regardless of PD-L1 expression level, demonstrated that cemiplimab helps patients live longer after progression from previous platinum-based chemotherapy. Cemiplimab as monotherapy is the first drug to have shown in a phase three study an improvement in overall survival in this difficult area for which we have no effective cure: And the result is even more important because in this study also adenocarcinomas, which are considered less sensitive. to immunotherapy, they benefit from the treatment.

March 22, 2021 (change March 22, 2021 | 20:03)

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