Prospects for patients with a difficult-to-treat disease significantly improve: survival is significantly prolonged for the first time
An important result, so much so as to change the current standard of care for women who have cervical cancer that is very difficult to treat: that it recurs despite treatment, that resists treatment or that has already reached the metastatic stage, spreading to others. organs. To highlight what the experts, gathered at the annual congress of the European Society for Medical Oncology (Esmo), consider a study with an immunotherapy drug added to traditional therapy, from which a significant lengthening of patient survival is achieved for the first time. Thanks to the vaccine against the Papillomavirus, that of the uterine cervix, a tumor that could disappear or become very rare, while in our country it still represents today the fifth most common cancer in women under 50 years of age.
First-line immunotherapy
The results of the experiment were illustrated during the presidential session, the main one, of Esmo 2021 by the Italian Nicoletta Colombo, director of the Medical Oncology Gynecology Unit at the European Institute of Oncology (Ieo) in Milan and lead author of the trial. Previous research had indicated that adding the anti-angiogenic drug (which stops or slows the growth of blood vessels used by the tumor to proliferate) bevacizumab to standard chemotherapy (paclitaxel with cisplatin or carboplatin) could prolong the survival of patients with almost four months – explains Colombo -. The KEYNOTE-826 study is the first to investigate the usefulness of adding the immunotherapy drug to chemotherapy, with or without bevacizumab pembrolizumab. The results indicate that, in any case, both progression-free survival and overall survival are prolonged. With acceptable and treatable toxicity. The study has enlisted 617 women with recurrent, persistent or metastatic cervical cancer who received immunotherapy with pembrolizumab or a placebo as a first line of treatment, along with traditional chemotherapy and, in some cases, the addition of bevacizumab. Outcomes show a 33% reduction in the risk of death in those treated with pembrolizumab and a 35% decrease in the odds of disease progression or death. The most common side effects were anemia (30.3% in the pembrolizumab group and 26.9% in the placebo group) e low concentration of white blood cells (12.4% versus 9.7%).
Vaccine, Pap test and Hpv-Dna test save life
Patients with this type of malignancy generally have a survival of no more than one year, but with the new strategy it is prolonged by eight months. The results obtained with the KEYNOTE-826 trial appear as a new important starting point – comments Colombo -. the first time we get such a significant extension of life, for this the study can change the current clinical practice. It is also important to note that pembrolizumab should be given together with bevacizumab when safe for patients, otherwise benefits can be obtained by just combining chemotherapy and immunotherapy. The next step will be to verify the efficacy of immunotherapy even in patients with an earlier stage of cancer. Cancer of the cervix (or cervix) counts 2,400 new cases per year, 99.7% of which caused by persistent papillomavirus (HPV) infection for which there is a vaccine offered free, in Italy, to 12-year-old males and females. Screening controls for early diagnosis then include the Pap-test, offered every 3 years to women between the ages of 25 and 30, e the test for HPV-DNA, offered every 5 years to women between 30 and 64 years old. If discovered in the early stages, this type of cancer can be treated less invasively and successfully, allowing the complete recovery of patients – concludes the expert -. In addition to the vaccine and life-saving screening checks, you need to watch out for symptoms such as abnormal loss or bleeding unrelated to menstruation, pain in the pelvis or back, sudden weight loss. In these cases, it is best to always speak to a gynecologist without delaying too much.
October 4, 2021 (change October 4, 2021 | 18:24)
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