Cervical cancer: patient survival lengthens with new drug

L’adding immunotherapy to standard chemotherapy extends survival by one year d
women with a cervical cancer persistent, recurrent or metastatic and prolongs their time free from disease progression. I indicate it final data from the KEYNOTE-826 study which will be presented at the next annual meeting of theAmerican Society of Clinical Oncology (Asco), scheduled to begin June 2 in Chicago.

I study

«The new results illustrate the follow-up over three years after the treatment of over 600 patients enrolled in the trial and clearly show i advantages that are obtained by also administering the immunotherapy drug pembrolizumab beyond to traditional chemotherapy, with or without bevacizumab – comments Nicoletta Colombo, director of the Oncological Gynecology Program at the European Institute of Oncology (IEO) in Milan and lead author of the study -. These are important improvements that support this strategy as a new first-line therapy in a group of patients with “difficult” to treat cervical cancer: it is the first time that we have managed to extend their life expectancy”.

The first time of immunotherapy

For the phase three trial (the last before official approval of a new drug) KEYNOTE-826 women with cervical cancer that recurs despite treatment, that resists treatment or that has already reached the metastatic stage, spreading to other organs. Participants received either pembrolizumab immunotherapy or a placebo as first-line treatment, along with traditional chemotherapy and, in some cases, the addition of bevacizumab. «Patients with this type of neoplasm generally have a survival of about a year, but with the new strategy the time available to them is doubled – explains Colombo, associate professor at the Milan-Bicocca University -. Previous research had indicated that combining the anti-angiogenic drug (which stops or slows the growth of blood vessels used by the tumor to grow) bevacizumab with standard chemotherapy (paclitaxel-based with cisplatin or carboplatin) could prolong the survival of patients with almost four months. KEYNOTE-826 is the first trial that has investigated the usefulness of associating the immunotherapy drug pembrolizumab».

The results of the study

The results obtained after about 39 months will be announced at the American Congress. “Progress is remarkable – comments Domenica Lorusso, associate professor of Oncological Gynecology at the Catholic University of the Sacred Heart in Rome -: the survival of patients treated with pembrolizumab is on average 26.4 months, while in the group that did not receive it is 16.8 months. Immunotherapy also reduces the risk of death by 37% while saving a few months in terms of time for disease progression. This new combination has already been approved by the US regulatory body (the Food and Drug Administration, FDA) and from the European one (European Medicines Agency, Ema) e not yet by the Italian Medicines Agency (Aifa), but in our country patients obtain it through “compassionate use” programs or through the free supply by the pharmaceutical company that produces it.

A tumor that could disappear

In our country, cancer of the neck of the uterus (or cervix) still represents the fifth most common cancer
in young women, under 50 years of age, with approximately 2,400 new diagnoses registered each year. But it is a type of cancer that could disappear thanks to the Papillomavirus or HPV vaccine, which is responsible for about 99.7% of cases. “The sexually transmitted HPV infection is the necessary condition for a carcinogenic process to begin at the level of the uterine neck, but there is a vaccine that in Italy is offered free to 12-year-old males and females (in some regions up to 26 years ) and which can also be useful for adults – recalls Lorusso -. Also the pre-cancerous lesions take many years to turn into cancer and, thanks to early diagnosis with Pap test and HPV-Dna test, they can be identified and removed in time, with different strategies available today. St
and discovered in the early stages this type of cancer can be successfully treated, allowing for the complete recovery of the patients. In addition to the vaccine and ai screening controlswhich save lives, is needed look out for symptoms such as abnormal spotting or bleeding unrelated to your period, pelvic or back pain, sudden weight loss. In these cases, it is always better to speak to a gynecologist without delaying too much ».