Treatment Of Cervical Cancer Research Articles

E2F1-Dependent CDCA5 overexpression drives cervical cancer progression and correlates with poor prognosis.

Cervical cancer (CC) remains a leading cause of cancer-related mortality in women worldwide, highlighting the urgent need for novel therapeutic strategies. This study investigates the molecular mechanisms and clinical significance of Cell Division Cycle Associated 5 (CDCA5) in cervical cancer progression. We performed comprehensive analyses of CDCA5 expression in cervical cancer and normal tissues, correlating expression levels with clinicopathological features and patient outcomes. Functional studies using CC cell lines (SiHa, HeLa, and CaSki) examined the effects of CDCA5 manipulation on tumor cell behavior. We identified E2F1 as a key transcriptional regulator of CDCA5 and validated our findings using in vivo xenograft models. CDCA5 was significantly upregulated in CC tissues and correlated with advanced disease stages and poor survival outcomes. Mechanistically, CDCA5 depletion in SiHa and HeLa cells suppressed proliferation, migration, and invasion, while its overexpression in CaSki cells enhanced these malignant properties. We identified E2F1 as a transcriptional activator of CDCA5. Importantly, CDCA5 knockdown significantly inhibited tumor growth in nude mouse models. Our findings establish CDCA5 as a critical E2F1-regulated oncogenic factor in cervical cancer progression. The strong correlation between CDCA5 expression and poor clinical outcomes suggests its potential as both a prognostic biomarker and therapeutic target in cervical cancer treatment.

Investigating the impact of persistent HPV infection on recurrence of lesions post-surgery for early-stage cervical cancer and related influencing factors

ObjectiveTo explore the influencing factors of recurrence after surgical treatment for early-stage cervical cancer (stages IA1-IIA1) and to investigate the relationship between human papillomavirus (HPV) infection and postoperative recurrence of lesions.MethodsA retrospective analysis was conducted on the clinical data of 242 patients who underwent surgical treatment for early-stage cervical cancer (FIGO stages IA1-IIA1) at the Second Affiliated Hospital of Dalian Medical University between 2015 and 2022. Cox regression analysis was employed to evaluate the relationship between persistent postoperative HPV infection and lesion vaginal local recurrence while identifying the associated risk factors for persistent HPV infection following surgery.ResultsWithin 12 months postoperatively, the HPV clearance rate was 88.11%. HPV infection persisted beyond 12 months in 19 patients (7.9%), with 3 cases demonstrating the same HPV genotypes (types 52, 58) as those identified preoperatively. Multivariate analysis identified persistent postoperative HPV infection (odds ratio [OR] 1.72, 95% confidence interval [CI] -1.14 to 5, p=0.001*) as an independent risk factor for recurrence. Additionally, smoking (OR 7.49, 95% CI 1.19 to 47.13, p=0.032), abnormal vaginal microbiota (OR 0.663, 95% CI 0.403 to 1.088, p=0.001*), and the type of surgical procedure (OR 0.32, 95% CI 0.11 to 0.91, p=0.033) were significantly associated with a higher rate of persistent HPV infection.ConclusionPersistent HPV infection after surgery is an independent risk factor for postoperative recurrence in early-stage cervical cancer. Surgical approach, abnormal vaginal microbiota, and smoking are associated factors for persistent HPV infection after surgery.

Resumption of Employment after Cervical Cancer Surgery: a 3-Year Follow-Up Study of Long-term Outcomes

INTRODUCTION. Despite advancements in cervical cancer (CC) diagnosis and treatment, surgical intervention remains the cornerstone of radical treatment. However, surgical procedures can result in complications such as lymphedema, sexual dysfunction, and other physical and psychosocial disorders, significantly affecting patients' quality of life (QoL) and ability to return to work. This emphasizes the need for effective strategies to support patients in resuming their occupational activities post-treatment. AIM. To investigate the relationship between different rehabilitation programmes following cervical cancer surgery and return to work MATERIALS AND METHODS. The study included patients aged 18 and older with stage 1A–1B cervical cancer. Patients were randomized into two groups: those receiving an active comprehensive rehabilitation program (СС-1, 51 patients) and those receiving passive rehabilitation (СС-2, 52 patients). The active rehabilitation program included a personalized, year-long regimen encompassing physical therapy, psychotherapeutic support, and lifestyle modifications, among other interventions. In contrast, the passive rehabilitation group received standard post-operative care information and general recommendations based on local clinical guidelines. The primary outcome was the proportion of patients who returned to work at various time points up to 36 months post-surgery. RESULTS. Patients in the СС-1 group demonstrated significantly higher rates of return to work compared to the CC-2 group from the third month post-surgery onwards. At 36 months, all patients in the CC-1 group had returned to work, whereas only 66.7 % of patients in the CC-2 group had resumed their professional activities. In the CC-1 group the chance of returning to work within 3 years after surgery was 2.14 times higher compared to those in the CC-2 group (OR = 0.467, 95 % CI 0.309–0.706, p 0.001). CONCLUSION. The study highlights the significant impact of personalized comprehensive active rehabilitation programs on improving the likelihood of return to work following surgical treatment for early-stage cervical cancer. These findings suggest that such rehabilitation approaches may be crucial in enhancing the long-term recovery and social reintegration of cervical cancer patients, ultimately contributing to better overall outcomes. Further research is needed to identify the most effective components of these rehabilitation programs and optimize their implementation.

Combination of Metabolomics and Bioinformatics to Reveal the Mechanism of Luteolin in the Treatment of Cervical Cancer.

The incidence of cervical cancer is high among women globally. The potential therapeutic efficacy of luteolin in the treatment of cervical cancer has been identified. Therefore, we aim to elucidate the mechanism of action of luteolin in the treatment of cervical cancer through a comprehensive approach that integrates metabolomics with bioinformatics. The first step involved the identification of differential metabolites through UHPLC-Q-Orbitrap-MS, which were then utilized for enrichment analysis of metabolic pathways and to determine the targets associated with these differential metabolites. Subsequently, the differential analysis and WGCNA were employed to identify DEGs and functional module genes respectively. The common targets were obtained by intersecting the results from the aforementioned three analyses, followed by conducting GO and KEGG pathway enrichment analysis on these targets. Subsequently, PPI networks were constructed using these common targets, and key targets were identified utilizing the MCC, EPC, Degree, Closeness Centrality, Betweenness Centrality, and Bottleneck algorithms in the CytoHubba plug-in. The subsequent steps involved the analysis of key genes for constructing a nomogram, conducting a ROC curve, examining content expression and survival analysis, and ultimately employing molecular docking to investigate the interaction between luteolin and crucial targets. The metabolomics analysis revealed the identification of a total of 45 distinct metabolites in this study, primarily associated with amino acid and nucleotide metabolism. The intersection of 773 differential metabolite targets, 3493 cervical cancer differential genes, and 3245 WGCNA-associated module genes yielded a set of 32 target genes associated with luteolin therapy for cervical cancer. The GO and KEGG pathway enrichment analysis also revealed that these targets were primarily associated with amino acid metabolism and nucleotide metabolism. The CytoHubba plug-in was utilized to identify three key genes (DMNT1, EZH2, and GMPS) through the application of multiple algorithms. Additionally, the datasets GSE63514, GSE67522, and GEPIA2 revealed a significant upregulation of all three genes in tumor tissue. ROC analysis demonstrated the good predictive ability of these three hub genes. Finally, the molecular docking results demonstrated the high binding affinity of luteolin towards DMNT1, EZH2, and GMPS. In conclusion, this study has unveiled the potential of luteolin in modulating amino acid and nucleotide metabolism for the treatment of cervical cancer, thereby providing a theoretical foundation for further investigation into the intricate association between luteolin and cervical cancer.

Significance of non-steroidal anti-inflammatory drugs in the prevention and treatment of cervical cancer

Significance of non-steroidal anti-inflammatory drugs in the prevention and treatment of cervical cancer

Global Review of Tools Evaluating Quality of Life in Cervical Cancer Survivors Treated With Chemoradiation Therapy.

This systematic review aimed to identify and compare tools used to evaluate quality of life (QoL) after pelvic radiation for cervical cancer and to describe variations in results within commonly used instruments. This review hypothesized regional preferences in the selection of these tools and an absence of uniformity in their application globally. A comprehensive search of 6 databases was conducted between the inception of each included database and June 14, 2023, focusing on studies evaluating the QoL of patients with cervical cancer during and after radiation. Excluded were studies involving cancers originating outside the cervix, those not exclusively undergoing radiation or chemoradiation therapy, such as patients who have undergone surgery, and non-English studies. Ultimately, 229 studies covering 25,693 patients and 51 countries were identified. Most studies were conducted in Asia (35.6%) and Europe (32.9%). Ninety-nine QoL instruments were identified, not including those that were specific to a single study. The European Organisation for Research and Treatment of Cancer QoL Questionnaire Core 30 (20.5%) and the European Organization for Research and Treatment of Cancer (EORTC) QoL questionnaire cervical cancer module (16.0%) were the most commonly used; however, US-based studies primarily used the Functional Assessment of Cancer Therapy-General surveys. Furthermore, there was significant variability in the timelines of survey usage in relation to when treatment was completed, further limiting the comparisons that can be made. Of the 127 studies that reported data on the time points after completion of treatment at which QoL was measured, 72.4% measured QoL within 1 year of treatment completion, and 48.8% measured QoL >1 year after treatment completion, with some studies using multiple time points for their research. This study revealed a fragmented landscape with significant variability in QoL survey use, limiting the generalizability and usefulness of these results to drive meaningful change. There is a need for a global standardized method to evaluate QoL after treatment of cervical cancer with radiation therapy for comparison across regions. Simplified tools may assist with the broader collection of data, which may lead to advancements for improvement of the QoL of these patients.

Insights on the prognostic value of visceral obesity in stage IVB cervical cancer treatment

Insights on the prognostic value of visceral obesity in stage IVB cervical cancer treatment

Recent advances in immunotherapy for cervical cancer.

Cervical cancer is the third most common malignant tumor in women worldwide in terms of both incidence and mortality. The field of cervical cancer treatment is rapidly evolving, and various combination therapies are being explored to enhance the efficacy of immune checkpoint inhibitors (ICI) and provide new treatment options for patients at different disease stages. Clinical trials involving immune checkpoint inhibitors are now being conducted following a phase 3 trial with cemiplimab, an ICI, which demonstrated a significant improvement in prognosis in advanced or metastatic cervical cancer patients. These trials include monotherapy and combination therapy with other immune therapies, chemotherapy, or radiation therapy. Furthermore, other approaches for controlling tumors via the immune system, such as therapeutic vaccination for specific tumor antigens or immune cell therapy including chimeric antigen receptor (CAR)-T cell therapy and tumor-infiltrating lymphocytes are being investigated. Ongoing trials will continue to illuminate the optimal strategies for combining these therapies and addressing challenges associated with immune checkpoint failure in cervical cancer. Herein, we conducted a review of articles related to immunotherapy for cervical cancer and describe current treatment strategies for cervical cancer via immunotherapy.

Investigating new drugs from marine seaweed metabolites for cervical cancer therapy by molecular dynamic modeling approach

The etiology of cervical cancer in women is attributed to the continuous infection of the human papillomavirus (HPV). The high costs and side effects of standard treatments and the limited efficacy of HPV vaccination have led to a quest for novel, cost-effective cervical cancer treatments, particularly in middle- and low-income countries. Therefore, our objective was to evaluate the capacity of marine seaweed compounds to hinder the activity of the cervical cancer E6 Oncoprotein. The Seaweed Metabolite Database was evaluated for its ability to inhibit E6 Oncoprotein functions by high throughput virtual screening. The investigations included molecular docking, ADMET test, MD simulation, and MM/GBSA analysis to identify three lead seaweed drug-like compounds: BC008 (-8.9 kcal/mol), RL379 (-8.9 kcal/mol), and BC014 (-8.7 kcal/mol). All of the leading candidates had positive characteristics in terms of pharmacokinetics, pharmacodynamics, and toxicity. The molecular dynamics simulation of the apoprotein, control drug, and lead compounds revealed the superior structural stability and uniformity of the main drug candidates. The MM/GBSA study revealed that the BC008-protein complex exhibited the most significant free binding energy, with a value of -57.41 kcal/mol. In the end, the findings derived from this investigation might provide a basis for developing innovative anticancer treatments.

Graphene oxide-enhanced photothermal therapy: laser parameter optimization and temperature modeling for hela cancer cell mortality.

Photothermal therapy, in which a laser is an effective tool, is a promising method for cancer treatment. Laser parameters, including power, irradiation time, type of laser radiation (continuous or chopped), and the concentration of the photothermal agent, can affect the efficiency of this method. Therefore, this study investigated and compared the effects of different laser parameters on the efficiency of photothermal treatment for cervical cancer, which is the fourth most prevalent cancer in women. In addition, we investigated the properties of graphene oxide (GO) synthesized as a photothermal agent under laser radiation, and its effectiveness in achieving the desired therapeutic temperature. This study examined and compared the effects of temperature, nanoparticle concentration, irradiation time, and laser power to understand their impact on heat transfer. The toxicity of graphene oxide at different concentrations in HeLa cancer cells was also evaluated. These results demonstrated low toxicity, particularly after 24h, with approximately 10% toxicity. The study explored mortality under laser irradiation at various powers and time intervals using continuous and chopped beam irradiation. In addition, a model for temperature prediction using a regression tree was presented. Finally, the combined photothermal effects of graphene oxide and laser irradiation were investigated. The MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) test results reveal significant effects, with a mortality rate of 90% in continuous radiation with a concentration of 0.3mg/ml and 75% in chopped beam irradiation with concentrations of 0.3 and 0.4mg/ml. A regression tree model was developed to predict temperature changes based on the GO concentration, laser power, and irradiation time, providing valuable insights for optimizing photothermal therapy parameters. Statistical analysis showed that the combined effect of graphene oxide with continuous laser irradiation was more effective than chopped-beam laser irradiation. However, the chopped-beam irradiation method is expected to cause less damage to surrounding tissues. These findings indicate that photothermal therapy with graphene oxide, chopped, and continuous laser irradiation can potently treat HeLa cancer cells and pave the way for further exploration of targeted cancer treatments.

The Use of 3D-CRT Technique in dose Distribution Analysis for Cervical Cancer Treatment Planning

Three Dimensional Conformal Radiotherapy (3D-CRT) is a technique used in designing a cancer treatment (treatment planning system) using radiation emitted through a gantry with direction, angle, number of fields, and radiation energy according to needs. Determination of direction, angle, number of fields, and radiation energy precisely aims to provide effectiveness in cancer treatment. The purpose of this study was to determine the efficient use of multiple gantry angles in cervical cancer using a LINAC machine with 3D-CRT technique. Data processing in this study was carried out using quantitative analysis techniques, namely descriptive statistics. This analysis technique uses secondary data obtained from the results of the description that has been carried out by doctors at the Radiotherapy Installation. Data processing was carried out by carrying out a treatment planning system on 7 patients with each patient receiving planning using 4 gantry angles and 6 gantry angles. These results are visualized in the form of tables and graphs of absorbed doses received by patients. Based on this study, it can be concluded that using the 3D-CRT technique in cases of cervical cancer, using 4 gantry angles is more efficient than using 6 gantry angles.

Artificial intelligence in high-dose-rate brachytherapy treatment planning for cervical cancer: a review

Cervical cancer remains a significant global health concern, characterized by high morbidity and mortality rates. High-dose-rate brachytherapy (HDR-BT) is a critical component of cervical cancer treatment, requiring precise and efficient treatment planning. However, the process is labor-intensive, heavily reliant on operator expertise, and prone to variability due to factors such as applicator shifts and organ filling changes. Recent advancements in artificial intelligence (AI), particularly in medical image processing, offer significant potential for automating and standardizing treatment planning in HDR-BT. This review examines the progress and challenge of AI applications in HDR-BT treatment planning, focusing on automatic segmentation, applicator reconstruction, dose calculation, and plan optimization. By addressing current limitations and exploring future directions, this paper aims to guide the integration of AI into clinical practice, ultimately improving treatment accuracy, reducing preparation time, and enhancing patient outcomes.

The combined immunization of cervical cancer therapeutic vaccine based on Listeria balanced lethal system has a significant therapeutic effect on tumor model mice.

Cervical cancer is the fourth most common cancer and the fourth leading cause of cancer death in women. Effective treatment of cervical cancer is urgently needed. Tumor therapeutic vaccine is a research hotspot in tumor immunotherapy, and the tumor therapeutic vaccine based on attenuated live bacteria carrier has clinical application prospect because of its clear action site and high safety. The bacterial balanced lethal system uses nutritional screening instead of antibiotic screening to avoid the risk of the spread of antibiotic resistance. So it is generally recognized as a green carrier. In our early research, we have constructed two cervical cancer therapeutic vaccine candidates (LM-HPVCW-1 and LI-HPVCW-1) based on Listeria balanced lethal system via transforming the nutrient-deficient strains with nutrition gene complementary plasmid. The complementary plasmid contained the nutrition complementary gene, LM dal gene, and its Amp gene was replaced with asd gene to delete the antibiotic resistance. Besides, it carried the shuffled HPV-16 E6E7 fusion protein gene. In vitro experiments showed that the plasmid carried by the candidate strain could be stably passaged and the target protein could be successfully expressed. In this study, we proved that the two candidate strains were safe in vivo and induced cellular immune response. At the same time, by establishing a tumor-bearing mouse model, it was proved that the two vaccine strains combined immunization could effectively inhibit mouse tumors. The mechanism of tumor suppression may be related to breaking the immunosuppression of tumor microenvironment and inducing CD8+ T cell infiltration. The therapeutic vaccine for cervical cancer constructed in this study is expected to be further applied in clinical practice.

Targeted Delivery of SmacN7 Peptide Induces Immunogenic Cell Death in Cervical Cancer Treatment.

Cervical cancer is a common tumor in women and one of the common causes of cancer death in women. Due to the aggressive and non-specific nature of traditional chemotherapy, there is a growing need for new treatment modalities. Currently, tumor immunotherapy is increasingly garnering attention as a disruptive treatment approach. Therefore, we constructed CCTP-SmacN7, a delivery system capable of releasing active molecules in the tumor microenvironment. CCTP-SmacN7 can not only inhibit tumor proliferation and migration, but also induce tumors to produce large amounts of reactive oxygen species. The production of reactive oxygen species can activate tumors to release or expose damage-associated molecular patterns, promote DC cell maturation, and ultimately activate T cells. Here, we present an innovative targeted treatment approach for cervical cancer. While inducing tumor immunogenic cell death, this program can also improve the tumor microenvironment and initiate the tumor immune cycle.

Anti-cancer activity of synthetic gefitinib-1,2,3-triazole derivatives against Hela cells via induction of apoptosis

Cervical cancer ranks as the fourth most common cancer among women. However, the current treatments have significant side effects and limited therapeutic effects on advanced diseases, so it is necessary to discover better treatments for cervical cancer. The current study investigated the potential anticancer effects of a series of gefitinib-1,2,3-triazole derivative on Hela cells. Among the investigated, the target compound c13 showed good anticancer activity against Hela cells (IC50 = 5.66 ± 0.35 μM) compared with gefitinib (IC50 = 14.18 ± 3.19 μM). Moreover, compound c13 significantly inhibited the colony formation ability of Hela cells in a dose-dependent manner, accompanied by morphological changes in HeLa cells. Further investigations demonstrated that compound c13 triggered cell apoptosis and arrested the cell cycle at the G2/M phase in Hela cells. In addition, western blot analysis revealed that compound c13 upregulated the Bax/Bcl-2 ratio, and increased the levels of active caspase 3 and PARP1 cleavage, which suggested the involvement of the mitochondrial pathway in compound c13-induced apoptosis. In brief, these results indicated that compound c13 is a promising compound for the treatment of cervical cancer.

Focus Groups With Guatemalan Community Leaders About Barriers to Cervical Cancer Prevention and Control.

Cervical cancer is the leading cause of cancer-related death among Latin American women, including Guatemalans. This is troubling, given we have a vaccine, screening tool, and treatment for this preventable disease. Human papillomavirus (HPV) causes most cervical cancer. HPV self-testing is a viable option for women in low-resource areas, such as Guatemala. More information is needed about barriers to HPV self-testing. We conducted four focus groups (N = 43) in three locations in San Raymundo with female community leaders to assess the lived experience of their attitudes, practices, and knowledge about cervical cancer. Participants shared barriers they face receiving Pap tests, the HPV vaccine, and self-testing for HPV. We concluded culturally targeted information is needed about cervical cancer prevention, screening, and treatment. Policies should include outreach to marginalized populations in remote areas with low-literacy indigenous Mayans. Practices should include partnerships with lay midwives and health promoters to help Guatemalan women self-test for HPV.

Editorial Comment: Key Elements of Pelvic MRI in Assessing the Feasibility of Fertility-Sparing Treatments for Early-Stage Endometrial and Cervical Cancers.

Editorial Comment: Key Elements of Pelvic MRI in Assessing the Feasibility of Fertility-Sparing Treatments for Early-Stage Endometrial and Cervical Cancers.

Locally Advanced Cervical Cancer in a Patient with Epidermolysis Bullosa Treated with Concurrent Chemoradiotherapy and Electronic Brachytherapy

Purpose: The purpose of this report is to investigate the feasibility of combined modality treatment in a case of locally advanced cervical cancer in a patient with inherited epidermolysis bullosa as well as to suggest a protocol for cervical electronic brachytherapy. Materials and Methods: The patient was treated with image-guided external beam radiotherapy and concomitant chemotherapy to a dose of 45 Gy in 25 fractions with a simultaneously integrated boost of 55 Gy in involved lymph nodes. The maximal skin dose was 34.09 Gy. Intracavitary electronic brachytherapy was applied to the uterine cervix in 4 fractions of 7 Gy and contributed no dose to the skin. Results: The treatment was tolerated well with no early toxicity. During the 3-month period of follow-up, no adverse events of grade 2 or higher were detected, and no exacerbation of skin lesions was noted. Conclusions: This is the first report of treatment of cervical cancer in a patient with inherited epidermolysis bullosa where combined concurrent chemoradiotherapy and intracavitary electronic brachytherapy demonstrated feasibility and safety. The followed institutional protocol for treatment planning and delivery ensured low doses to organs and risk and reproducibility.

Advancing the Fight Against Cervical Cancer: The Promise of Therapeutic HPV Vaccines.

Human papillomavirus (HPV) is a major global health issue and is recognized as the leading cause of cervical cancer. While prophylactic vaccination programs have led to substantial reductions in both HPV infection rates and cervical cancer incidence, considerable burdens of HPV-related diseases persist, particularly in developing countries with inadequate vaccine coverage and uptake. The development of therapeutic vaccines for HPV represents an emerging strategy that has the potential to bolster the fight against cervical cancer. Unlike current prophylactic vaccines designed to prevent new infections, therapeutic vaccines aim to eradicate or treat existing HPV infections, as well as HPV-associated precancers and cancers. This review focuses on clinical studies involving therapeutic HPV vaccines for cervical cancer, specifically in three key areas: the treatment of cervical intraepithelial neoplasia; the treatment of cervical cancer in combination with or without chemotherapy, radiotherapy, or immune checkpoint inhibitors; and the role of prophylaxis following completion of treatment. Currently, there are no approved therapeutic HPV vaccines worldwide; however, active progress is being made in clinical research and development using multiple platforms such as peptides, proteins, DNA, RNA, bacterial vectors, viral vectors, and cell-based, each offering relative advantages and limitations for delivering HPV antigens and generating targeted immune responses. We outline preferred vaccine parameters, including indications, target populations, safety considerations, efficacy considerations, and immunization strategies. Lastly, we emphasize that therapeutic vaccines for HPV that are currently under development could be an important new tool in fighting against cervical cancer.

Enhanced targeted treatment of cervical cancer using nanoparticle-based doxycycline delivery system

This study investigates a nanoparticle-based doxycycline (DOX) delivery system targeting cervical cancer cells via the CD44 receptor. Molecular docking revealed a strong binding affinity between hyaluronic acid (HA) and CD44 (binding energy: -7.2 kJ/mol). Characterization of the HA-Chitosan nanoparticles showed a particle size of 284.6 nm, a zeta potential of 16.9 mV, and a polydispersity index of 0.314, with SEM confirming smooth surface morphology. The encapsulation efficiency of DOX-loaded nanoparticles was 89.32%, exhibiting a sustained release profile, with 67.45% released over 72 h in acidic conditions (pH 5.5). Cytotoxicity assays demonstrated a significant reduction in HeLa cell viability to 22% at 72 h, compared to 67% in normal HEK cells. Stability tests confirmed the maintenance of nanoparticle integrity and a consistent drug release profile over three months. Cell migration was reduced by 45%, and RT-PCR analysis revealed a 53% downregulation of TNF-α expression, suggesting effective targeting of inflammatory pathways. These results underscore the potential of HA-Chitosan-based DOX nanoparticles in improving cervical cancer treatment through enhanced targeted delivery and inhibition of tumor-promoting mechanisms.