Dr. Tewari on the Evolution of Treatment in Cervical Cancer

Krishnansu Tewari, MD, associate professor, Division of Gynecologic Oncology, University of California, Irvine, discusses the evolution of treatment in cervical cancer.

The most important improvements in the treatment paradigm have been those in supportive care, says Tewari. In the United States, cervical cancer is commonly found in women who do not have access to healthcare and therefore do not have the opportunity to get Pap smears or the HPV vaccine. Therefore, at the time of diagnosis, the disease is often very advanced. These patients’ medical comorbidities are often just as severe.

Physicians have learned that supportive care is just as important as the corresponding therapeutic agent. This was especially true in the trial with bevacizumab (Avastin), notes Tewari. Physicians have made tremendous strides in managing medical comorbidities, correcting malnutrition, and optimizing pain management, states Tewari. Even though these are high-risk patients, they are healthier than they were before, which means that they will be able to better tolerate novel drugs.

Researchers are now limiting the performance status on clinical trials to 0 and 1, whereas in the past patients with an ECOG performance status of 2 could have been enrolled.