Immunotherapy: A Game Changer in the Battle Against Cervical Cancer

For the first time in two decades, physicians wield a formidable arsenal against cervical cancer. Spearheading this medical revolution are combination therapies that harness the power of immunotherapy medications, boosting the body’s immune system to fight disease.

Almost all cases of cervical cancer are caused by a viral infection that is spread primarily through sexual contact ― the human papillomavirus (HPV). Immunotherapy drugs such as bevacizumab and pembrolizumab play a crucial role in stimulating the immune system, uncovering the masking mechanism some cancer cells exhibit, helping other cells better recognize and attack virus-infected cells and ultimately slowing or halting the spread of disease.

John Diaz, M.D., chief of gynecologic oncology at Baptist Health Miami Cancer Institute

“The addition of immunotherapy to frontline treatment has been exciting,” says John Diaz, M.D., chief of gynecologic oncology at Baptist Health Miami Cancer Institute. “We are seeing great improvement. It’s a multipronged approach that has resulted in improved survival.”

A newer class of drugs, called antibody-drug conjugates (ADCs), also show great promise, particularly for those with later-stage cervical cancer. Researchers are studying the effectiveness of combining ADCs with immunotherapy medications and other treatments. In addition, thanks to a growing understanding of genomics, doctors are better able to use information from the molecular testing of a patient’s tumor to individualize care.

“We are excited we have these advances, but we are always looking for other ways to improve care,” says Dr. Diaz. “Cancer has a way of figuring out how to evade treatment, so approaching it with different therapies is important.”

While on the decline, cervical cancer is diagnosed in approximately 14,000 women each year. That’s 14,000 women too many, Dr. Diaz emphasizes.

 “Cervical cancer should be eradicated,” he says. “Between the HPV vaccine and the screenings we have available, we can find cancer in the early stages, when it is most treatable and, most importantly, we can prevent it.”

The HPV vaccine was first approved in 2006 for children ages 9 and up, and in 2018 the FDA expanded its approval for use in women and men through the age of 45. In addition to causing cervical cancer, HPV can lead to vulvar cancer and vaginal cancer in women and a number of head and neck cancers in both men and women.

“We recommend that everyone be vaccinated before they are sexually active. This gives the body’s immune system time to develop antibodies to the virus,” Dr. Diaz says.

Health experts say that Australia is well on its way to becoming the first country to eliminate cervical cancer, thanks primarily to a government vaccination and screening program. “Australia is a great success story,” Dr. Diaz says. “We need to do a better job here, making sure that everyone has access to the vaccine, that underserved communities can be vaccinated and that everyone is educated about HPV and cancer.”

In addition to the vaccine, women should be screened regularly, having an HPV test and Pap tests, which can detect pre-cancerous cells and cancer in its earliest stage ― even before symptoms like abnormal bleeding, pelvic pain or vaginal discharge occur. If unsure about the best screening schedule for you, speak to your primary care physician or OB/gyn. To reduce risk for all cancers, women should not smoke and should exercise, maintain a healthy weight, eat well and manage their stress.

Dr. Diaz is leading clinical trials in a variety of gynecologic cancers. For more information on clinical trials at Miami Cancer Institute, click here.