Abstract
Treatment options for women with metastatic, persistent, or recurrent cervical cancer are limited and thus the disease portends a poor prognosis. It is critical to understand the pathophysiology of cervical cancer to better delineate therapeutic targets. The development of antiangiogenic therapies and their subsequent analysis in rigorous therapeutic trials have redefined current management strategies and is an exciting area of current exploration. Translational trials have furthered the understanding of molecular determinants of angiogenesis. Phase II trials have shown promising trends with developing antiangiogenic therapies. A practice-changing phase III trial has recently been published. Given the potential benefits and different toxicity spectrum compared with standard cytotoxic chemotherapy, antiangiogenic options are under active investigation for this vulnerable patient population. Emerging data are promising for other antiangiogenic-directed therapeutics, as well as cervical cancer molecular biomarkers to guide diagnosis and treatment. Antiangiogenic therapies have evolved during the past 20 years and remain an exciting area of current exploration. Understanding of the angiogenic microenvironment has furthered understanding of tumor biology and management. Antiangiogenic therapies show promise for women with advanced cervical cancer. A review of the evolution of these biologic agents shows them to be an effective and tolerable management strategy for many patients in this vulnerable population, with exciting future potential.
Highlights
On the global scale, numerically, cervical cancer remains the most lethal gynecologic malignancy, with 529,800 new cases and 275,100 deaths in 2011 [1]
Because of effective screening and early detection through the Papanicolaou test and improving dissemination of the human papillomavirus (HPV) vaccine, cervical cancer is less prevalent in the U.S.; it continues to be a severe burden, with 12,990 new cases diagnosed and 4,120 deaths in 2016 alone [2]
This study demonstrated improved progression-free survival and improved tolerability of this alternative antiangiogenic agent in women with advanced cervical cancer
Summary
Cervical cancer remains the most lethal gynecologic malignancy, with 529,800 new cases and 275,100 deaths in 2011 [1]. Antiangiogenic therapies show promise for women with advanced cervical cancer. In vivo evaluation by Li et al showed that nuclear OCT4A was responsible for the selfrenewal of cervical cancer stem cells, whereas cytoplasmic OCT4B enhanced angiogenesis and promoted tumor mobility.
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