Novel Treatment Concepts for Cervical Cancer-Moving Towards Personalized Therapy

Area of Science:

• Gynecologic Oncology
• Radiation Oncology
• Medical Oncology

Background:

• Cervical cancer treatment has evolved with new randomized trials.
• Personalized medicine allows treatment escalation for high-risk disease and de-escalation for low-risk patients, reducing morbidity.
• Landmark studies are influencing clinical practice and patient outcomes.

Purpose of the Study:

• To provide a comprehensive analysis of recent landmark studies in cervical cancer therapy.
• To highlight advances in surgical, radiotherapeutic, and systemic treatment options.
• To discuss the impact of personalized treatment concepts on clinical practice.

Main Methods:

• Review of recent randomized controlled trials and prospective studies.
• Analysis of surgical techniques, including simple hysterectomy and sentinel lymphadenectomy.
• Evaluation of image-guided adaptive brachytherapy (IGABT) and immune checkpoint inhibitors (CPIs).

Main Results:

• Simple hysterectomy is non-inferior to radical hysterectomy for low-risk cervical cancer, with improved quality of life.
• Sentinel lymphadenectomy is replacing systematic pelvic lymphadenectomy in low-risk patients.
• MRI-guided IGABT is state-of-the-art for locally advanced cervical cancer (LACC).
• Combination chemotherapy with pembrolizumab is a new standard for metastatic/recurrent PD-L1 positive cervical cancer.
• Neoadjuvant chemotherapy and adjuvant CPI therapy are being evaluated for LACC.

Conclusions:

• Personalized treatment strategies, including surgical de-escalation and advanced therapies, are transforming cervical cancer care.
• Sentinel lymphadenectomy and less invasive surgery improve outcomes for low-risk patients.
• Immunotherapy and advanced radiotherapy techniques offer new hope for advanced and recurrent cervical cancer.