ESMO E-Learning: Treatment of Advanced Cervical Carcinoma

In this E-Learning module the authors elaborate the global burden of cervical cancer worldwide, explaining discrepancy in incidence and mortality between developing and developed countries, emphasizing that prevention is key and digging into primary and secondary prevention coverage and effectiveness, explain differences in revised staging, survival outcomes, deep into pivotal practice changing results of clinical studies conducted in women with advanced disease, and elaborate promising early phase approaches.

The authors underline that cervical cancer is a malignancy with the largest inter-country range of variation in mortality among all cancers, caused by differences in availability of cervical cancer screening, HPV infection prevalence and implementation of HPV vaccination.

The focus of this module is on systemic treatment in recurrent and metastatic setting. The authors made a significant effort to describe and put into context the results from the pivotal trials and show progress made in the management of women with cervical cancer. They underline that platinum/paclitaxel/bevacizumab/pembrolizumab is a new standard of care for metastatic and recurrent disease in patients with PD-L1-positive tumours and draw attention to option of replacing cisplatin with carboplatin.

The authors elaborate the findings from trials investigating antiangiogenic agents, immune checkpoint inhibitors and antibody drug conjugates that led to regulators’ approvals or where the results are expected and provide an overview of currently recruiting trials. They state that promising early approaches include T-cell receptor gene therapy, tumour infiltrating lymphocytes, and CAR T cells.

In this module, the authors also elaborate main features of cervical neuroendocrine carcinoma and explain the palliative aspects of cervical cancer care.