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Ninety-nine percent of cervical cancers are caused by or attributable to HPV, notes Warner K. Huh, MD. This ubiquitous target makes cervical cancer the most attractive solid tumor for an immunotherapy approach, Huh suggests. Unfortunately, immunotherapy clinical trials in the cervical cancer setting are not producing promising results—most likely, Huh suggests, due to the poorly functioning immune systems of the women enrolling in these studies. Efficacy, he adds, may depend not only on which agent is tested, but on the mode of administration.
There are other challenges to studying cervical tumors, adds Michael J. Birrer, MD, PhD, including the rarity of the tumor type in the United States, and the patient population affected is usually socioeconomically challenged. Beyond immunotherapy, there are other targets being explored, including PI3 kinase pathway, which is activated in 25% of cervical tumors, Birrer says. Additionally, there has been significant interest in the EGFR pathway.