Hope for New Cervical Cancer Treatments
Data on HPV in women have prompted researchers to elicit more options and better outcomes. And while there is a vaccine available for HPV few people take advantage of it for various reasons. HPV has been linked to cervical cancer-seems pretty straightforward. Take the vaccination to decrease the chance of cervical cancer.
Cervical cancer is the fourth most common cancer for women. Even so, it is the leading cancer-related death in developing countries. This study found HPV, human papillomavirus, is responsible for nearly all cases of cervical cancer and 95% of anal cancers. It is the most common sexually transmitted disease infecting more than 79 million Americans. And while there is a vaccine against HPV few take advantage of it for a variety of reasons. This virus has been a difficult one for researchers to find a treatment/cure for. Recently these researchers found that HPV makes use of a protein already present in our cells and the enzyme USP46 to cause HPV-induced tumor production. It is hoped by researchers that by inactivating USP46, they will be able to shut down the growth of this cancer (Kiran et al, 2018).
The evolution of precancerous cervical lesions is poorly understood. HPV infections account for an estimated 530,000 new cervical cancers and 270,000 deaths each year. There are more than 25 types of HPV that are transmitted through sexual contact. The main goal of this study was to see if DNA methylation events were associated with progression of cancer cells. The study also found when multiple lesions were of the same grade they often was infected with the same type of HPV. The researchers admit there were some limitations in their study. A definitive study would need a lengthy possibly decades of follow-ups with a large population of women with HPV. The study did find single lesion with accurate results to assist to avoid over-treatment of women. Reducing the numbers of younger women treated by surgical excision to preserve their reproductive status (Nedjai et al, 2018).
Work done so far
Persistent high-risk HPV infection is the primary cause of cervical cancer. Human papillomavirus-based cervical screening can identify more than 95% of pre-cancerous cervical lesions grade two or more. The researchers observed moderate baselineensitivity and a high sensitivity for CIN3 and cancer among HPV positive women. The strength of this study was that the study samples were obtained from a cervical screening program. An important limitation of the case-controlled study was that it was retrospective because the trial was not designed specifically to assess prospectively additional molecular triage in HPV positive women. Additional studies will be needed to validate the results of this study. But it did how that this method can detect a greater proportion of high-grade disease with a high short-term risk of cervical cancer (Cook et al, 2018).
The immune system is increasingly recognized as an important component of tumor detection and destruction. The problem has been many cancers have developed mechanisms of resistance to avoid detection by the immune system. Much of immunotherapy so far has focused on targeting inhibitory receptors on T-cells. And although this has worked well with other tumors, gynecological cancers have only had a moderate success rate. There are more than 13,000 cases of cervical cancer with over 4000 deaths each year in the US. And even though treatments have improved for early-stage cervical cancer, survival rates are still poor. As a predominantly virally mediated cancer, cervical cancer may be uniquely amendable to immunotherapy and combinations are being presently tested. There is particular interest in utilizing immunotherapy to make it easier for host recognition of cervical cancers (Liu et al, 2018).
Looking forward with hope
While there is an encouraging trend in cancer research, more work is needed. For every life saved there are still people waiting for the next break through. Fundamental cancer biology research is uncovering new molecular pathways that are being explored as potential therapeutic agents. And we are entering a time where care by biomedical research is no longer driven by just doctors and researchers. Patients are also pushing this forward by offering tissue samples to help research themselves. However, the funds to promote this research are often lacking. The result of a decreased budget, researchers are unable to recruit and retain young researchers and that can threaten future progress against cancer. In addition the cost of cancer care can be devastating financially causing some patients to either refuse treatment or skip does in order to afford it (Heymach et al, 2018).
This study compared a new epigenetic-based (epigenetic a change in gene function without changes in the DNA sequence) cervical cancer test with pap smear and HPV tests and investigated how well it predicted the development of cervical cancer up to five years in advance in a large study of women in Canada. Rather than check for patterns in the DNA genetic code itself, the new test looks at the naturally-occurring chemical markers that appear on top of the DNA. This is the first time that a test can detect cervical cancer 100% of the time. The epigenetic changes are what this test picks up and why it works so well. The test also detected adenocarcinoma, a type of cervical cancer that is very difficult to treat (Lorincz et al, 2018).
Cervical cancer is the fourth most common cancer in women worldwide with more than 85% of cervical cancer deaths happening in the less-developed countries. It is felt that many of these deaths occur due to the needed infrastructure, expertise, and funding needed is lacking. Cervical Cancer Research Network is focusing on potential methods of treating advance stage cervical cancers. Unfortunately cervical cancer remains one of the leading causes of cancer death among women. Many challenges exist in managing cervical cancer. Cervical Cancer Research Network is working to decrease global disparity in cervical cancer treatment by offering low-cost clinical trials to improve the level of care of all women no matter the country of origin. To reach this goal, further research is needed in all areas of the world (Ager et al, 2018).
Ager, B.J. et al. (2018). Advancing clinical research globally: Cervical cancer research network from Mexico. Gynecologic Oncology Reports, 25: 90-93
Cook, et al. (2018). Evaluation of a validated methylation triage signature for HPV positive women in HPV focal cervical screening trial. International Journal of Cancer.
Heymach, J. et al. (2018). Clinical cancer advances 2018: Annual report on progress against cancer from the American society of clinical oncology. Journal of Clinical Oncology, 36(10).
Kiran, S. et al. (2018). Human papillomavirus discovery raises hope for new cervical cancer treatments. University of Virginia Health System.
Liu, Y. & Zamarin, D. (2018). Combining immune checkpoint blockade strategies to maximize immune response in gynecological cancer. Current Oncology Reports, 20(94).
Lorincz, A. et al. (2018). New cervical cancer test has 100 percent detection rate. Queen Mary University in London. International Journal of Cancer.
Nedjai, B. et al. (2018). Molecular progression to cervical cancer, epigenetic switch or sequential model. International Journal of Cancer.