ABSTRACT
Several groundbreaking clinical trials with the potential to transform the management paradigm of both locally advanced and persistent, recurrent, or metastatic cervical cancers have been presented in 2023. This review describes the reported data from INTERLACE and KEYNOTE-A18 in the locally advanced setting, as well as BEATcc, innovaTV 301 and DESTINY-PanTumor02 for advanced disease. The practice implications of their positive results are interpreted in the context of global health considerations, and updated treatment algorithms are proposed. Furthermore, emerging trends in drug development for cervical cancer are discussed. As the routine use of immune checkpoint inhibitors (ICIs) for curative and palliative indications increases in the foreseeable future, patients whose cervical cancers which persist, relapse or progress after prior ICI exposure will represent an area of unmet clinical need and form the key target population for next-generation trials. Future research will help shape oncologists' approaches in the optimal selection, sequencing and re-treatment or rechallenge of immuno-oncology agents and/or antibody-drug conjugates in women with cervical cancer.
Subject(s)
Uterine Cervical Neoplasms , Humans , Female , Uterine Cervical Neoplasms/pathology , Immunotherapy/methods , Neoplasm Recurrence, Local/drug therapy , Neoplasm Recurrence, Local/pathologyABSTRACT
INTRODUCTION: The National Lung Screening Trial (NLST) identified individuals at high risk for lung cancer and showed that serial low-dose helical computer tomographic scans (CT) were able to identify lung cancer at an earlier stage and also demonstrated mortality reduction. However, there has been little evidence regarding the effectiveness of the Lung Cancer Screening Criteria in the Asian population. METHODS: To determine lung cancer patients who miss out on Lung Cancer screening criteria, we performed a retrospective audit from January to December 2018 in our hospital, and describe the characteristics of our patients diagnosed with lung cancer. RESULTS: We found that only 38.1% of the patients in our cohort who were diagnosed with lung cancer in 2018 fitted into NLST Criteria strictly by age and smoking criteria. However, those who fitted the inclusion criteria of lung cancer screening would derive significant benefits, as 85.4% presented at advanced stage and 54.6% did not survive one year. We explored using the United States Preventive Services Task Force criteria, which increased sensitivity to 58.7% of identifying our patients with diagnosed lung cancer. 15.5% of females with lung cancer in our cohort fitted into NLST Criteria, but their low smoking quantity is a significant contributing factor for females being excluded. CONCLUSION: Majority of Singapore patients diagnosed with lung cancer would not have been picked up by NLST Criteria, especially female patients. However, those who fitted the inclusion criteria would derive significant benefit, while expanding to an older limit may yield benefits with improved sensitivity.