Immunotherapy, a cutting-edge approach to cervical cancer treatment, has emerged as a promising option for patients. This article explores the role of immunotherapy in treating cervical cancer, the impact of Human Papillomavirus (HPV), recent breakthroughs in cervical cancer therapies, the importance of early detection, and real-life success stories.

Understanding Immunotherapy in Cervical Cancer Treatment

Cancer immunotherapy is a revolutionary treatment approach that leverages the body’s immune system to recognize and combat cancer cells more effectively. Unlike traditional treatments like chemotherapy and radiation, which directly target cancer cells, immunotherapy stimulates the immune system to identify and destroy cancer cells. The advantage of immunotherapy lies in its ability to target cancer cells without causing significant damage to surrounding healthy tissues, unlike chemotherapy and radiation.

Cervical cancer is commonly linked to HPV, which leaves behind viral proteins that the immune system can recognize as foreign. Immunotherapy works by enhancing the body’s immune response to these viral proteins, allowing the immune system to better target and eliminate the cancer cells.

Immunotherapy is increasingly being used in combination with other treatments such as chemotherapy, radiation, and surgery. It is particularly beneficial for recurrent cervical cancer and is also being tested as a first-line treatment alongside other therapies.

The Role of HPV in Cervical Cancer

The primary cause of cervical cancer, HPV, is a sexually transmitted infection that can lead to changes in cervical cells, which may eventually develop into cancer. While most HPV infections are short-lived and resolve on their own, persistent infections with high-risk strains like HPV 16 and HPV 18 can cause precancerous lesions. Over time, these lesions may develop into cervical cancer. These two high-risk strains of HPV are responsible for approximately 70% of cervical cancers.

Recent Breakthroughs in Cervical Cancer Treatment

The past few years have seen significant breakthroughs in the treatment of cervical cancer, particularly with the approval of new drugs and the refinement of existing therapies.

Pembrolizumab: This immunotherapy drug has been approved by the FDA for advanced or recurrent cervical cancer. Pembrolizumab blocks a protein that prevents immune cells from attacking cancer cells, helping the immune system target the cancer more effectively.

Tisotumab Vedotin (TV): This is an antibody-drug conjugate that has received FDA approval. The drug targets cancer cells with high precision, reducing damage to healthy tissues.

In addition to these breakthroughs, new surgical techniques and combination therapies are improving patient outcomes. For example, induction chemotherapy, which involves a short course of chemotherapy before standard treatment, has shown promise in reducing the risk of recurrence and improving survival rates. The INTERLACE trial demonstrated that six weeks of induction chemotherapy before concurrent chemoradiation helped more patients survive without their cancer returning.

The Importance of Early Detection in Cervical Cancer

When diagnosed at an early stage, cervical cancer is highly treatable and even curable. The earlier the cancer is detected, the more treatment options are available, which significantly improves the chances of successful treatment.

Women should be proactive about seeking medical advice if they notice unusual symptoms, such as bleeding between periods, or after menopause or sexual intercourse. Other symptoms may include increased or foul-smelling vaginal discharge, back or pelvic pain, swelling in the legs, vaginal discomfort, and unexplained weight loss.

Early detection tools include regular screenings such as Pap smears and HPV testing, which can help identify precancerous lesions or changes in cervical cells before they turn into cancer, reducing the risk of cancer progression.

The advancements in immunotherapy and early detection are providing new hope for patients and improving survival rates. With continued research, innovation in treatment approaches, and the widespread use of preventive measures like HPV vaccination and regular screening, the fight against cervical cancer is becoming more effective than ever.

Case Study: A Real-Life Success Story

A 49-year-old woman was diagnosed with cervical cancer in 2019 and initially treated with chemoradiation. However, in 2023, she was diagnosed with recurrent metastatic cervical cancer, which had spread to her liver, lungs, and abdominal nodes. A repeat biopsy was done, and her PD-L1 score came back as 20%. Based on this, she was treated with the new standard of care – a combination of immunotherapy (pembrolizumab) and chemotherapy (paclitaxel + carboplatin).

After three cycles of treatment, her disease showed significant improvement. By the end of six cycles, there was no evidence of disease remaining. She recently completed one year of immunotherapy, and her latest scan revealed that her disease is in complete response.

This case highlights the potential of immunotherapy in transforming the prognosis for patients with recurrent and metastatic cervical cancer, offering them a chance for long-term remission and improved quality of life.

About the author- Dr. Upasana Palo, Associate Consultant – Gynecologic Oncology, Narayana Hospital RN Tagore Hospital, Mukundapur