Cervical cancer is a type of cancer that affects the cervix, which is the lower part of the uterus that connects to the vagina. It is the 4th leading cause of cancer deaths in women worldwide, with over 500,000 new cases diagnosed worldwide each year (1). Conventional treatment for cervical cancer typically involves a combination of surgery, radiation therapy, and chemotherapy.
Most cases of cervical cancer are driven by infection with human papillomavirus (HPV), which uses multiple mechanisms to avoid immune surveillance. Several types of immunotherapies that stimulate the immune system have been created to address this issue and enhance treatment outcomes. These agents include immune checkpoint inhibitors (ICI), therapeutic vaccines, modified T cells, and antibody-drug conjugates.
Immune checkpoint inhibitors (ICIs), are a promising treatment option for many types of cancer, including gynecological cancers but are still in its early exploration stages of testing for Cervical Cancer. However, there is strong evidence to support its use as a treatment option, particularly since cervical cancer is caused by a virus and should theoretically be recognized by the immune system as foreign.
The two main pathways that are currently exploited in clinical practice are the cytotoxic T lymphocyte-associated protein 4 (CTLA-4) pathway and the programmed cell death 1 (PD-1) pathway. (2)
In 2021 the FDA approved two new immunotherapy treatments for cervical cancer, the antibody-drug conjugate tisotumab vedotin (Tivdak) and the checkpoint inhibitor pembrolizumab (Keytruda).(3)
One of the obstacles to using immunotherapy for cervical cancer is determining which patients will benefit from the treatment. It is currently estimated that only about 20-30% of patients respond to these drugs, which underscores the need for more accurate predictive biomarkers to help select patients for treatment.
There is a significant amount of evidence to support the idea that the spatial analysis of Tumor Micro-Enviroment (TME) and immune parameters can predict which patients are more likely to respond to immunotherapy and tailor treatment accordingly. This approach could improve treatment outcomes and reduce the cost and toxicity of immunotherapy.
At Nucleai, we are dedicated to improving the lives of cervical cancer patients and our platform has been used to analyze a clinical trial of a novel checkpoint inhibitor tested in cervical cancer by a leading pharma companies in an attempt to identify better predictive biomarkers from pathology data and improve patient clinical outcome.
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Sung H., Ferlay J., Siegel R.L., Laversanne M., Soerjomataram I., Jemal A., Bray F. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J. Clin. 2021;71:209–249. doi: 10.3322/caac.21660.
S.J. Otter, J. Chatterjee, A.J. Stewart, A. Michael, The Role of Biomarkers for the Prediction of Response to Checkpoint Immunotherapy and the Rationale for the Use of Checkpoint Immunotherapy in Cervical Cancer, Clinical Oncology, Volume 31, Issue 12, 2019, Pages 834-843,