Treatment for cervical cancer- characterized by uncontrolled growth of cells in the cervix, will witness a significant demand in the coming years, considering early diagnosis of cervical cancer arising from increased awareness among women. As per the American Cancer Society, nearly 13,240 new cases of invasive cervical cancer will be diagnosed in US, by the end of 2018 and nearly 4,170 women would succumb to cervical cancer.
Increased Use of HPV, Pap-Test to Drive Cervical Cancer Treatment Landscape, Specifically in Low-Resource Economies
As per world cancer statistics, nearly 80 percent of cervical cancer cases are found in women in low-resource and developing nations. Apart from lack of awareness, difficulties in conducting cytology-based screening programs also play a major role in delaying cervical cancer treatment, in such economies including India. Medical experts emphasize on having a robust pre-screening protocol, which is essential in detecting early cervical epithelial changes.
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Pap-Smear test remains the single largest screening test for detecting early stage of invasive cervical cancer and precancerous cervical intraepithelial neoplasia. In the United States, Center for Disease Control and Prevention (CDC)-sponsored National Breast and Cervical Cancer Early Detection Program (NBCCEDP) helps women get timely screening—both uninsured and insured low-income women. Studies indicate nearly 60 percent reduction in cervical cancer death, after the implementation of Pap-Smear Test.
However, in Australia, on the other hand, the government-funded initiative National Cervical Screening Program (NCSP) is aimed at reducing cervical cancer cases in the region. In December 2017, under this program, the pap test was replaced with a Cervical Screening Test that looked at the human papillomavirus (HPV)—cause of nearly cervical cancer in 99 percent cases. Several studies also indicate HPV tests being more accurate than pap-smear for cervical cancer screening. Moreover, the American Society of Clinical Oncology, called for quantifiable trials of HPV testing to test the efficacy of HPV tests over pap-smear.
Immunotherapy, Targeted Therapies Could Soon Become Frontline Cervical Cancer Treatment Choices
Although cervical cancer treatment has undergone significant refinement in the last two decade, patients with FIGO stage IIB-IVA (locally advanced disease) often fail to achieve complete response to CCRT (concurrent chemo-radiation) – with either Cisplatin or in combination. Research and medical experts are developing advanced approaches to improve outcomes of cervical cancer treatment. For instance, an inhibitor of vascular endothelial growth—bevacizumab (mostly sold under the trade name Avastin)—is said to showcase improved result in recurrent or metastatic cervical cancer cases when used along with chemotherapy. Researchers are also exploring the prospects of adjuvant chemotherapy given to patients with stage III-IVA disease and positive lymph nodes and tumor volume, after CCRT. Apart from combination therapies, cervical cancer treatment options involving targeting molecular pathways with innovative agents, are also being studies.
In addition, immune-based therapies, has been touted as the most promising alternative to prevent, treat, and cure cancer. Oncologists and medical experts are anticipated to study the effectiveness of immunotherapy, for cervical cancer treatment, including checkpoint inhibitors-for blocking cancer cells’ ability to harm the immune system and treatment vaccines- for inducing a response against the cancer cells. For instance, Axalimogene filolisbac, already studies in six clinical trials, is being touted as the most unique immunotherapy for HPV-related cancers.
Clinical Trials, Research and Development Gains Prominence among Key Manufacturing Companies
Institut Curie, recently launched a new clinical trial, under the name of NiCOL, with a focus on patients suffering from late-stage cervical cancers. Aimed at assessing the optimal dosage of Nivolumab, monoclonal antibodies, researchers are said to assess the clinical effectiveness of NiCOL, along with its immunological and genetic mechanisms during the pelvic chemo-radiotherapy stage.
Iovance Biotherapeutics, Inc, on the other hand, are studying the efficacy of LN-145, an autologous tumor-infiltrating lymphocyte (TIL), aimed at providing a second-line option for cervical cancer treatment—recurrent metastatic, and persistent. In a sponsored study by National Institutes of Health (NIH), TIL therapy showed thorough regression of metastatic cervical cancer.
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Under more such developments, the US Food and Drug Administration
(FDA), granted its approval to Keytruda, developed by Merck, after its
got priority review for cervical cancer treatment, in March 2018.