January is Cervical Health Awareness Month

Nearly all cases of cervical cancer are associated with human papilloma virus (HPV) infection, a discovery that has fueled development of screening and prevention strategies.² These strategies include HPV screening as well as regular Pap tests, which detect precancerous cells before they become malignant. As a result of these screening strategies, the number of cases of cervical cancer and the number of deaths from the disease have decreased significantly in the US.³ The importance of these screening tests are also illustrated in the varying 5-year survival rate depending on stage of disease at diagnosis; 5-year survival rate is over 90% in stage 0 disease, but drops to less than 20% in advanced disease stages.⁴

New cases of cervical cancer in the US have dropped significantly since 2006, when the first HPV vaccine was approved by the Food and Drug Administration (FDA). Since then, two additional HPV vaccines have been approved. However, despite advances in vaccination against the causative agent, patients continue to be diagnosed with advanced stage cervical cancer.

For these patients, surgery, radiation therapy, and chemotherapy have been the mainstay of treatment.⁵ Unfortunately, though, these treatments have failed to significantly improve overall survival.⁶ As such, there is ongoing research into the development of immunotherapies for the treatment of cervical cancer. These immunotherapies seek to stimulate the patient’s own immune system to recognize and subsequently destroy cancer cells more efficiently. Currently, in addition to the three HPV vaccines, one targeted antibody and one immune checkpoint inhibitor have been FDA-approved for the treatment of cervical cancer. The targeted antibody, bevacizumab, is a monoclonal antibody that inhibits tumor blood vessel growth by targeting the vascular endothelial growth factor (VEGF)/VEGF receptor pathway.⁷ The immune checkpoint inhibitor, pembrolizumab, targets programmed cell death protein 1 (PD-1), a protein on T cells that normally prevents these immune cells from attacking "self."8 By blocking PD-1, pembrolizumab augments the body’s immune response to cancer cells, thereby shrinking the tumor and/or slowing its growth.

Numerous other immunotherapies for the treatment of cervical cancer are currently in clinical trials. These include vaccines, targeted antibodies, adoptive cell therapy, and immunomodulators. As January is Cervical Health Awareness Month, now is the perfect time to learn more about these developing therapies.