A new clinical study has found that erlotinib, a targeted antitumor agent, has promising potential to improve treatment for cervical cancer. The results indicate that larger trials are warranted to determine whether the drug should become part of standard therapy for women with the disease.
Nearly half a million new cases of cervical cancer are reported worldwide each year, making it the third most common cancer among women. Despite the widespread use of screening programs and the recent advent of vaccines against human papilloma virus, cervical cancer continues to be a significant public health problem.
Many patients present at later stages, when 5-year survival rates are poor. Initial therapies offer the best hope for a cure, while persistent or recurrent disease has a poor prognosis. However, the study’s authors explained that there has been a dearth of clinical trials since the late 1990s in this area. This study was published in Cancer (2014; doi:10.1002/cncr.28471).
Cisplatin-based chemoradiation is the standard therapy for locally advanced cervical cancer. Unfortunately, treatment responses are unpredictable and often disappointingly brief. A potentially promising new treatment strategy involves targeting the epithelial growth factor receptor (EGFR), which is frequently overexpressed in cervical cancer. Inhibiting this receptor is known to have antitumor effects against a variety of cancers.
Angélica Nogueira-Rodrigues, MD, PhD, of the Brazilian National Cancer Institute, in Rio de Janeiro, Brazil, and her colleagues designed a phase 2 clinical trial to test the potential of the EGFR inhibitor erlotinib combined with chemoradiation therapy in 36 women with cervical cancer. Median duration of therapy was 77 days and median follow-up time was 59.3 months.
The therapy was well tolerated overall, and 34 patients (94.4%) achieved a complete response (meaning the disappearance of all cancerous lesions). After 2 years, 91.7% of women were alive, and 80.6% experienced no progression of their disease. After 3 years, 80% of women were alive, and 73.8% experienced no disease progression.
“While cervical cancer is a neglected disease and very few clinical trials have been reported in the last 10 years, some groups, including ours, have reported that its biology might be prone to targeted therapy,” said Nogueira-Rodrigues. “To the best of our knowledge, this is the first study to present that a targeted agent has promising activity in the management of locally advanced cervical disease.” She added that targeted therapies may be added to the standard treatment for locally advanced cervical cancer if randomized trials confirm the current study’s results.