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Immunotherapy and Cervical Cancer

FAQs: Immunotherapy and Cervical Cancer

  • by Sajjan Rajpurohit
  • 05 Feb, 2021

Q.1 What is Cervical Cancer?

Ans. The cervix is the lower, narrow end of the uterus (the hollow, pear-shaped organ where a fetus grows). The cervix leads from the uterus to the vagina (birth canal). Cervical cancer occurs in the cells of the cervix..

Q. 2 What are Different Types of Cervical Cancer?

Ans. The main types of cervical cancer are:

  • Squamous cell carcinoma.
  • Adenocarcinoma.
  • Very rarely, cancer occurs in other cells in the cervix.

Q. 3 Enumerate the Risk Factors for Cervical Cancer?

Ans. Risk factors for cervical cancer include:-

  1. Many sexual partners.
  2. Early sexual activity.
  3. Other sexually transmitted infections (STIs).
  4. A weakened immune system.
  5. Smoking (Associated with squamous cell cervical cancer.)
  6. Exposure to miscarriage prevention drug.[Drug called diethylstilbestrol (DES)- associated increased risk of a certain type of cervical cancer called clear cell adenocarcinoma as reported in literature]

Q. 4 What is Most Common Cause for Cervical Cancer?

Ans. Cause of cervical cancer:-

  1. Cells in the cervix develop changes (mutations) in their DNA.
  2. Various strains of the human papillomavirus (HPV), a sexually transmitted infection.

Q. 5 How Our Body Tell Us About Change in Cell Population of Cervix Leading to Cervical Cancer?

Ans. [Early-stage cervical cancer generally produces no signs or symptoms]

Symptoms of cervical cancer:-

  1. Vaginal bleeding after intercourse, between periods or after menopause
  2. Watery, bloody vaginal discharge that may be heavy and have a foul odor
  3. Pelvic pain or pain during intercourse

Q. 6 Reducing the Risk of Cervical Cancer by Approaches of Prevention and Screening:-

Ans. Prevention:-

  • Receiving a vaccination to prevent HPV infection may reduce the risk of cervical cancer and other HPV-related cancers. Ask your doctor whether an HPV vaccine is appropriate for you.
  • Practice safe sex. Reduce your risk of cervical cancer by taking measures to prevent sexually transmitted infections, such as using a condom every time you have sex and limiting the number of sexual partners you have.
  • Don’t smoke. If you don’t smoke, don’t start. If you do smoke, talk to your doctor about strategies to help you quit.

Screening:-

Have routine Pap tests. Pap tests can detect precancerous conditions of the cervix, so they can be monitored or treated in order to prevent cervical cancer.

Diagnosis of cervical cancer requires that a sample of cervical tissue (called a biopsy) be taken and analyzed under a microscope. This would be done if the Pap smear is abnormal.

If a biopsy under colposcopy suggests an invasive cancer, a larger biopsy is needed to fully evaluate your condition. Treatment will depend on stage of the cancer.

Q.7. What are Different Treatment Options for Cervical Cancer?

Ans. Different types of treatment are available for patients with cervical cancer.

  1. Surgery (removing the cancer in an operation)
  2. Radiation therapy
  3. Chemotherapy
  4. Targeted therapy (Bevacizumab is used to treat cervical cancer that has metastasized (spread to other parts of the body) and recurrent cervical cancer)
  5. Immunotherapy
  6. Clinical trials of new anticancer drugs or drug combinations.

Q. 8 Immunotherapy and Cervical Cancer….IS IT A PROMISING ARM OF TREATMENT IN CERVICAL CANCER?

Ans. Yes definitely as Treatment involves selecting, multiplying and re-infusing cancer-fighting immune cells. It is used to treat cervical cancer that has spread or come back (recurred). Reported data is available with ample research work. Also good disease free survival time frame is achieved for the concerned enrolled patients.

An immunotherapy approach uses immune cells with known cancer-fighting ability tumor-infiltrating lymphocytes (TILs), led to complete or partial tumor shrinkage in about 40% of people with advanced cervical cancer as per reported literature.

  1. Pembrolizumab (Keytruda) targets PD-1; these drugs boost the immune response against cancer cells. This can shrink some tumors or slow their growth.
  2. Bevacizumab (targeted to VEGF vascular endothelial growth factors ) approved to be used alone or with other drugs to treat Cervical cancer both recurred and spread. It is used with paclitaxel and either cisplatin or topotecan hydrochloride. This use is approved for both the Avastin and Mvasi brands of bevacizumab.
  3. Persistent complete response after third- line treatment with nivolumab for relapsed, chemotherapy-resistant cervical squamous cell carcinoma has shown the promising potential of immunotherapy.
  4. CAR T- cell therapy in Cervical cancer: NCT03356795 Clinical trial 2017 safety and efficacy of CAR T cells immunotherapy in patients who have GD2, PSMA, Muc1, Mesothelin or other markers positive cervical cancer is under recruiting phase.
  5. TIL therapy: In a study by Amir Jazaeri, MD, of MD Anderson Cancer Center in Houston, and colleagues evaluated cryopreserved LN-145 TIL therapy for women with recurrent, persistent or metastatic cervical cancer (study NCT03108495). The overall response rate in this study was 78% of reduction in tumor burden.

Q. 9 What are Side Effects of Immunotherapy in Cervical Cancer?

Ans. Side effects of these drugs can include fatigue, fever, nausea, headache, skin rash, loss of appetite, constipation, joint/muscle pain, and diarrhea. Other, more serious side effects occur less often.

Q. 10 Combination Immunotherapy in Cervical cancer?

Ans. Patients with recurrent or metastatic cervical cancer may have new hope in an immunotherapy combination.As tumors react to the treatment combination of Opdivo (nivolumab) and Yervoy (ipilimumab), both immune checkpoint inhibitors, regardless of tumor PD-L1 expression as per reported clinical trials in process. Researchers found that the combination worked better in patients who didn’t receive prior therapy compared with those who did.