Update on Immunotherapeutic Strategies for Recurrent and Metastatic Cervical Cancer: Bradley Monk, MD, FACS, FACOG, and Jennifer Filipi, MSN, FNP-C

There are an estimated 13,800 new cases of cervical cancer in the United States each year, and 4,290 people die of the disease (ACS, 2020). Deaths have declined during the past few decades due to screening and heightened awareness, yet this malignancy continues to be a global health concern and is considered an epidemic in parts of the world. A significant proportion of patients develop advanced disease, which is rarely curable with available therapies, and treatment is often limited to palliati...

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FDA Approves Pembrolizumab Combination for Cervical Cancer

The FDA has granted approval to pembrolizumab (Keytruda®, Merck) in combination with chemotherapy, with or without bevacizumab, for patients with persistent, recurrent, or metastatic cervical cancer whose tumors express programmed death-ligand 1 (PD-L1). The FDA has also granted regular approval to single-agent pembrolizumab for patients with recurrent or metastatic cervical cancer whose tumors express PD-L1, with a combined positive score of ≥1, who experienced disease progression on or after c...

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Tisotumab Vedotin Approved for Recurrent/Metastatic Cervical Cancer

The FDA has granted accelerated approval to tisotumab vedotin-tftv (TivdakTM, Seagen) for patients with recurrent or metastatic cervical cancer who experience disease progression on or after chemotherapy. "Few effective second-line treatments exist for women with recurrent or metastatic cervical cancer," wrote Robert Coleman, MD, Chief Scientific Officer of the US Oncology Network, and colleagues, in their publication of results of the phase 2 innovaTV/GOG-3023/ENGOT-cv6 trial, on which the appr...

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Image Guided Intensity Modulated Radiotherapy Reduces Bowel Toxicity in Cervical Cancer

A recent phase 3 study presented at the American Society for Therapeutic Radiology and Oncology (ASTRO) 2020 Annual Meeting found that patients with cervical cancer undergoing postoperative adjuvant conventional radiation are more likely to develop late bowel toxicity than those undergoing image guided intensity modulated radiotherapy (IG-IMRT). For this study, results of which are published in the International Journal of Radiation Oncology, Biology, Physics, 300 patients aged 18 to 65 years ol...

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Cancer Overscreening High Among Older Adults

Overscreening for colorectal, cervical, and breast cancer is prevalent among older adults in the United States, according to the results of a new study. While routine cancer screening for adults with average cancer risk is recommended by the US Preventive Services Task Force (USPSTF), it is recommended that screening be discontinued once individuals reach a specified upper age limit, defined as age 75 for colorectal cancer, age 65 for cervical cancer, and age 74 for breast cancer. However, many ...

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Noninvasive Nanoscale Test Accurately Detects Bladder Cancer

Researchers have developed an accurate, noninvasive diagnostic test that can be used for a number of cancers. Their success in applying this test to the detection of bladder cancer makes it the first to effectively utilize atomic force microscopy (AFM) for diagnostic purposes. Bladder cancer is one of the most common cancers and one of the most common causes of cancer-related death. If it is detected in stage 0, bladder cancer has a five-year survival rate of 98%; if it is detected at an advance...

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HPV+ Without CIN: Still at Risk for Cervical Cancer

A cellular abnormality called cervical intraepithelial neoplasia (CIN) is a precursor for cervical cancer. However, scientists have now found that women who are positive for human papillomavirus (HPV) and negative for CIN are still at a very high risk for developing cervical cancer. In a study published in the journal Cancer, researchers identified 576 healthy women through the National Cervical Screening Registry who were screened between 2005 to 2007 and tested negative for CIN. During a follo...

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Throat, Not Cervix, Is Now Most Common HPV-Linked Cancer Site

According to a new report published by the Centers for Disease Control and Prevention (CDC), oropharyngeal squamous cell carcinoma (SCC), a cancer of the throat, has replaced cervical carcinoma as the cancer most commonly associated with human papillomavirus (HPV). Human papillomavirus, the most commonly sexually transmitted infection in the United States, is a known cause of cervical cancer and some types of oropharyngeal, vaginal, vulvar, penile, and anal cancers. According to the CDC report, ...

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Epigenetic Cervical Cancer Test Yields 100% Detection Rate

Researchers recently developed a cervical screening exam that is able to accurately identify cervical cancer using epigenetics. At a fraction of the cost, this new epigenetic test outperformed Pap smears and human papillomavirus (HPV) exams in detecting cervical cancer by identifying naturally-occurring chemical markers that show up on top of the DNA, comprising its epigenetic profile. "This is an enormous development. We're not only astounded by how well this test detects cervical cancer, but i...

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Adding PET to CT Scan for Cervical Carcinoma Staging Leads to Change in Treatment

 A study recently published in JAMA Network Open has found that for patients with newly diagnosed stage IB to stage IVA cervical carcinoma, using positron emission tomography (PET) in combination with computed tomography (CT) results in increased detection of paraaortic or common iliac adenopathy compared with CT alone. According to the study authors, around 40% of cervical cancer patients have locally advanced disease at the time of their diagnosis, meaning that the cancer extends to the v...

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HPV Vaccine Approval Expanded Through Age 45

​In a step crucial to preventing the occurrence of both the human papillomavirus (HPV) and HPV-related cancers, the United States Food and Drug Administration (FDA) has expanded the approval of the 9-valent human papillomavirus (9vHPV) vaccine (Gardasil®9, Merck and Co.) for men and women between the ages of 27 and 45. The human papillomavirus infects approximately 14 million Americans each year. It is also a well-documented cause of a number of cancers, including cervical carcinoma and orophary...

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Learning Needs: Checkpoint Inhibitors in Cervical Cancer

Pre-activity assessment data from i3 Health's continuing medical education (CME)/continuing nursing education (CNE) activity "Optimizing the Management of Advanced Cervical Cancer With Checkpoint Inhibitor Therapy" has revealed significant baseline knowledge gaps in the area of checkpoint inhibitor therapies for advanced cervical cancer. Three hundred and ninety-seven learners took part in the educational activity and completed the pre-activity assessment, and 375 of these finished the activity ...

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The Bacterial Microbiome Plays a Role in Cervical Cancer

Almost all (99%) of cervical cancers stem from certain strains of human papillomavirus (HPV) that cause precancerous lesions. In a recent study, scientists report that the cervical bacterial microbiome plays a crucial role in the development of HPV and, in turn, in the development of cervical cancer. In the study, which was published in mBio, the journal of the American Society for Microbiology, the investigators used cytobrush swabs to collect samples from cervical lesions from 144 Tanzanian wo...

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Could Cervical Cancer Be Eliminated Worldwide by 2099?

​Cervical cancer is the fourth most common cancer in women, with approximately 570,000 cases diagnosed worldwide during the year 2018. Yet because this cancer most frequently results from specific strains of the human papillomavirus (HPV) for which a vaccine is now FDA-approved in individuals up to the age of 45, it is becoming largely preventable. With this in mind, the World Health Organization called last year for the elimination of cervical cancer as a public health problem. A team of Austra...

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Eliminating Cervical Cancer Worldwide: An Interview With Karen Canfell, DPhil

Cervical cancer is the fourth most common cancer in women globally, yet because it most often results from specific strains of the human papillomavirus (HPV) for which a vaccine is now available, it is becoming largely preventable. Addressing a call from World Health Organization (WHO) to eliminate cervical cancer as a public health problem, a team of researchers led by cancer epidemiologist Karen Canfell, DPhil, investigated whether it would be possible to wipe out this disease worldwide by the...

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Which Cervical Cancer Screening Is Most Cost-Effective?

A variety of cervical cancer screenings are available in the United States. However, the benefits, harms, and costs of all testing options are not known. In order to find out the cost-effectiveness of each type of cervical cancer test, researchers conducted a study analyzing 12 testing strategies. For this study, published in JAMA Internal Medicine, 451 women aged 21 to 65 years were enrolled. Each woman was asked her preference regarding 23 cervical cancer screening-associated health states. Th...

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Immuno-Oncology and Checkpoint Inhibition in Cervical Cancer: Bradley Monk, MD, FACS, and Ramez Eskander, MD

​Unlike that of other gynecological malignancies, the etiology of cervical cancer is the human papillomavirus (HPV). This fact plays a role in how cervical cancer is perceived as immunogenic: T cells themselves are involved in the immune response and in the control of viral infections and the development of these tumors. In this discussion with i3 Health, Bradley Monk, MD, FACS, FACOG, Professor of Gynecologic Oncology at the University of Arizona and Creighton University, and Ramez Eskander, MD...

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