The evolution of treatment for advanced cervical cancer: from cisplatin monotherapy to immuno-oncology combinations

Cervical cancer is one of the most common malignant tumors in Russia. Despite the high cure rates with local treatment approaches (eg, surgery or radiothearapy) at early stages of the disease, metastatic cervical cancer portends an unfavorable prognosis. The incidence and mortality rates over the last 10 years remain at a consistently high level. The backbone of treatment for metastatic cervical cancer is platinum-based combinations – the cytototic combination of paclitaxel and cisplatin (or carboplatin) being a standard-of-care treatment for patients with metastatic disease. However, chemotherapy alone failed to achieve satisfactory long-term treatment outcomes – the expected life expectancy with chemotherapeutic drugs rarely exceeds 12 months. One of the most fruitful directions in the treatment of metastatic cervical cancer to date is immunotherapy – in particular, pembrolizumab, a PD-1 pathway inhibitor – one of the key checkpoints of the immune response control. This review article highlights historical and recent achievements in metastatic cervical cancer treatment. It highlights the development of anticancer medications for advanced or metastatic cervical cancer, including targeted antiangiogenic therapy, immunotherapy, and the latest research data on the effectiveness of combining these classes of drugs with standard cytotoxic chemotherapy to achieve the best treatment outcomes.