Chemoradiation — combining radiation and chemotherapy — is usually the standard treatment for many patients with cervical cancer in all but the most advanced stages of the disease. The chemotherapy drugs used during chemoradiation are often cisplatin or cisplatin plus fluorouracil, and the radiation therapy includes both external beam radiation and brachytherapy. Sometimes chemo is given without radiation for a period before chemoradiation is started — chemo may also be used alone after the radiation therapy has stopped.
Chemotherapy drugs are used to treat cervical cancer that has recurred after treatment. When the cancer has metastasized to other organs and tissues, outside of the pelvis, this stage of cervical cancer is not usually considered curable. However, chemotherapy, used with radiation or alone, may be useful in slowing the growth of the cancer and helping to relieve symptoms.
Most standard chemo regimens include a platinum drug (cisplatin or carboplatin) given with another chemo drug, such as paclitaxel (Taxol), gemcitabine (Gemzar), or topotecan, the American Cancer Society points out.
Targeted therapy for cervical cancer
As researchers have learned more about how malignant cells grow and change, they’ve come up with new drugs and other therapies that specifically fight cancer by targeting cellular changes. Targeted therapies work differently from standard chemotherapy. Although, like chemo, they attack specific cancer cells, they don’t harm normal cells.
Some targeted therapies are being used to help treat advanced cervical cancer.
Monoclonal antibody therapy is a type of targeted therapy made from antibodies created in the lab from one type of immune system cell, the National Cancer Institute explains. These antibodies lock onto substances on cancer cells or normal substances that aid cancer growth. By attaching to these substances, the monoclonal antibodies kill the cancer cells, stop the cells from growing, or keep them from spreading.
Given by infusion, monoclonal antibodies may be used alone or, like stealth anti-cancer weapons, to carry drugs, toxins, or radioactive material directly to malignant cells.
For example, in order to grow and spread, cancer tumors need angiogenesis — the process of forming new blood vessels to keep tumors nourished. Bevacizumab (Avastin) is a targeted therapy created to block this new blood vessel growth. Called an angiogenesis inhibitor, bevacizumab is a monoclonal antibody that works to fight cancer by binding to a specific protein, vascular endothelial growth factor (VEGF), that cancerous tumors need to make new blood vessels.
Bevacizumab is now being used in the medical arsenal to help slow down and treat cervical cancer that has spread to other parts of the body and to treat cervical cancer that has recurred after other treatments have stopped working.
This targeted therapy is frequently used with chemo for a time. Then, if the cancer’s growth is stopped, the chemotherapy may be halted and bevacizumab given by itself until the cancer starts growing again.
March 18, 2020
Janet O’Dell, RN