Systemic treatment of cervical cancer

Abstract

In this section, we review the systemic management of patients with cervical cancer (CC) at different stages of disease: locally advanced, metastatic, or recurrent. The roles of chemoradiotherapy, neoadjuvant chemotherapy, and palliative chemotherapy, as well as of biological therapy, in this pathology are also discussed. Since the end of the 1990s, different meta-analyses have supported the use of combination chemoradiotherapy based on evidence of an increase in overall survival. Certain studies have reported that neoadjuvant chemotherapy offers a benefit similar to that obtained with chemoradiotherapy in patients with advanced tumors (larger than 4 cm) or complications such as hydronephrosis but with fewer side effects; however, these inferiority data do not support a change in the standard treatment. Angiogenesis inhibitors are an efficacious, promising therapy in CC. Recent clinical studies in metastatic and/or recurrent cancer suggest that new signaling pathways in CC can be explored to identify novel molecular targeted therapies in order to obtain better outcomes for patients with this disease. Some of the therapies for infrequent histologic types are also briefly reviewed.