Anti-angiogenesis agents in metastatic or recurrent cervical cancer

Abstract While the incidence of cervical cancer has declined significantly in the United States, it still remains a serious American health threat. When detected early, cervical cancer is generally curable. Early lesions are treated surgically, and locally advanced lesions are managed with concurren...

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Bibliographic Details
Published in:Gynecologic oncology 2010-02, Vol.116 (2), p.181-186
Main Authors: Monk, Bradley J, Willmott, Lyndsay J, Sumner, Daniele A
Format: Article
Language:English
Subjects:
Angiogenesis
Angiogenesis Inhibitors - therapeutic use
Female
Hematology, Oncology and Palliative Medicine
Humans
Metastatic cervical cancer
Neoplasm Metastasis
Neoplasm Recurrence, Local - blood supply
Neoplasm Recurrence, Local - drug therapy
Neoplasm Recurrence, Local - pathology
Neovascularization, Pathologic - drug therapy
Obstetrics and Gynecology
Therapy
Uterine Cervical Neoplasms - blood supply
Uterine Cervical Neoplasms - drug therapy
Uterine Cervical Neoplasms - pathology
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Summary:Abstract While the incidence of cervical cancer has declined significantly in the United States, it still remains a serious American health threat. When detected early, cervical cancer is generally curable. Early lesions are treated surgically, and locally advanced lesions are managed with concurrent cisplatin chemotherapy and pelvic radiation. Metastatic disease or recurrent lesions not amenable to radical local excision or regional radiation are treated with palliative chemotherapy. Current chemotherapeutic regimens are associated with significant side effects and only limited activity making the identification of active and tolerable novel targeted agents a high priority. Angiogenesis is central to cervical cancer development and progression. The dominant role of angiogenesis in cervical cancer seems to be directly related to HPV inhibition of p53 and stabilization of HIF-1 alpha, both of which increase VEGF. Bevacizumab binding and subsequent inactivation of VEGF seem to shrink cervical tumors and delay progression without appreciable toxicity, and are therefore being studied in a Gynecologic Oncology Group (GOG) phase III trial. Other intracellular tyrosine kinase inhibitors (TKIs) of angiogenesis such as pazopanib are also encouraging, especially in lieu of their oral administration. Further study of angiogenesis and its inhibition are ongoing.
ISSN:0090-8258
1095-6859
DOI:10.1016/j.ygyno.2009.09.033