Advances in gynaecological cancer research could change the treatment landscape, say researchers

Advances in gynaecological cancer research could change the treatment landscape, researchers have said, allowing women struggling with these cancers to live longer.

Results from highly anticipated clinical trials in gynaecological cancers with, among others, new data that cover the entire spectrum of managing patients with cervical cancer, will be presented at the ESMO Congress 2023 in Madrid, Spain.

These studies, researchers say, could change the treatment landscape for women with these cancers, delaying the time to relapse and, in some cases, lengthening survival.

“These are exciting results that address unmet needs in gynaecological cancers,” says Professor Krishnansu S. Tewari, director of the Gynecologic Oncology Programme, University of California, Irvine.

Novel findings will be revealed at the congress across the range of gynaecological cancers, including cervical, ovarian, and endometrial cancers.

Cervical cancer usually presents as locally advanced disease in women who have not undergone screening. At this stage, the cancer is too large to remove surgically, and the standard treatment is chemotherapy with radiation.

“Cervical cancer occurs in young women who are typically in the midst of their careers and have small children at home,” explains Tewari.

“Standard treatment does lead to remission, but within two to three years the cancer can come back. Two trials that will be presented at the ESMO Congress 2023 will reveal new ways of treating locally advanced cervical cancer that significantly delay relapse, giving women who are in the prime of their lives more time free of cancer.”

In one study, 68 per cent of women who received the immunotherapy drug pembrolizumab on top of standard treatment were cancer-free at two years, compared to 57 per cent of women allocated to placebo on top of standard treatment.

A second study tested the impact of giving a combination of two different chemotherapy drugs ahead of standard treatment with chemotherapy plus radiation, a strategy called induction chemotherapy.

Women with locally advanced cervical cancer who received induction chemotherapy were 35 per cent more likely to be cancer-free at five years and 39 per cent more likely to be alive at five years compared to those who received standard treatment only.

Tewari says: “Induction chemotherapy could be an accessible treatment option because these drugs are available around the world, including in low-resource countries.”

Also in cervical cancer, trials will be presented showing improvements in survival and delays in relapse with new treatments for women with cancer that has spread to other parts of the body or has come back after being treated.

In ovarian cancer, achieving remission is a high unmet need, say scientists, as approximately 85 per cent of patients experience recurrent disease, with almost no long-term survival after recurrence.

At the ESMO Congress 2023, randomised trial data will be discussed showing that a novel targeted therapy, called senaparib, could delay the time to relapse in patients with newly diagnosed advanced disease.

Studies will also be presented in endometrial cancer, the most common gynaecological cancer in the US and Europe.

While there is no screening test for endometrial cancer, there is an early symptom, post-menopausal bleeding, which means that most endometrial cancers can be cured with a hysterectomy.

“Unfortunately, for the 15-20 per cent of patients that have more aggressive disease, treatment options are very limited and that’s why the studies that will be presented at the ESMO Congress are remarkable,” says Professor Tewari.

“Two trials showed that adding immunotherapy to standard chemotherapy treatment significantly delayed relapse of the cancer in women with advanced/recurrent endometrial cancer compared to chemotherapy alone.”

The researcher thinks the results that will be presented at the ESMO Congress 2023 have a very good chance of leading to regulatory approval of new treatments.

He says: “These trials have set the stage for women with gynaecological cancers to receive state-of-the-art therapies that delay the time to relapse, allowing women struggling with these cancers to live longer and live better.”