The combined use of theimmunotherapy con chemo and radiotherapy is able to improve overall survival in the forms of cervical cancer locally advanced. An extraordinary result that will change clinical practice, the result of the intuition of the Italian non-profit research MITO (Multicenter Italian Trials in Ovarian cancer and gynecologic malignancies). The results were presented at the congress ofEuropean Society for Clinical Oncologyone of the most important global events in the fight against cancer.
CERVICAL CANCER
Every year in Italy there are approximately 2400 new cases in the year of cervical cancer uterine. Caused mainly by an infection from virus HPVit is estimated that it causes the death of about 500 women every year. Fortunately, it is a slow-growing tumor. This is why, by undergoing regular check-ups and tests such as Pap test o HPV-testit is possible to intercept any lesions that over time could transform into tumors.
TREATMENT OF LOCALLY ADVANCED FORMS
In metastatic forms, immunotherapy has already proven useful in controlling the disease, at least for a while. The real challenge, however, concerns the locally advanced forms which represent approximately 70% of all diagnoses. «In the last 20 years, the progress made in the treatment of this tumor has not concerned the locally advanced forms. In all this time, the standard treatment has always been based on the use of chemotherapy and of the radiotherapy» explains Professor Domenica Lorusso, director of the Gynecological Oncology Program at Humanitas San Pio X in Milan.
THE ROLE OF IMMUNOTHERAPY
A situation that has finally been unblocked thanks to the positive data obtained in the clinical trial KEYNOTE-A18 presented at ESMO. The study was “designed” a few years ago by Italian scientists from MITO coordinated by Professor Lorusso (Multicenter Italian Trials in Ovarian cancer and gynecologic malignancies). The first encouraging results were presented at the last ESMO congress. Now the definitive confirmation has arrived: adding theimmunotherapy with pembrolizumab to standard therapy with chemo and radiotherapy is the best strategy to treat these tumors. One fact above all: the overall survival At 3 years, it reached 82.6% in newly diagnosed patients who received the immunotherapy regimen compared to 74.8% for those who were treated with chemo-radiotherapy alone.
CHANGE THE STANDARD OF CARE
“For the first time in over 20 years in which there has been no real progress, this combination changes the standard of care. The addition of pembrolizumab immunotherapy to chemoradiotherapy will allow us to bring about a potential healing a greater number of patients. In fact, we remember that this is a potentially curable stage of the disease” explains Lorusso. A change of scenario possible thanks to the role of Italian research: “The KEYNOTE-A18 study highlights thehigh level of Italian researcherswhich are able to open new avenues in the challenge of the disease – explains Franco Perrone, President of AIOM (Italian Association of Medical Oncology). Cervical cancer often affects young women, busy with their profession and family, with small children. Furthermore, it is a very symptomatic and painful neoplasm, which prevents a social life. Hence the importance ofinnovation which offers therapies that improve survival and allow us to achieve, in some cases, the very important goal of healing.”
THE ROLE OF PREVENTION
As new therapies are finally emerging after decades of substantial stagnation, it is essential to emphasize the importance of prevention per i cervical tumors. Almost all of these tumors are caused by HPV infection, but fortunately for years there has been a Vaccine capable of neutralizing the virus. In countries like Australia, where the vaccination was introduced early among adolescents, a significant reduction in HPV-related tumors was observed. In Italy, it is urgent to improve vaccination coverage, which is still insufficient among both males and females. Furthermore, the vaccination It is also recommended for those who are already positive for HPV, since the vaccine can still contribute to prevent the development of the disease.