Cervical Cancer Treatment Update: A Society of Gynecologic Oncology Clinical Practice Statement

Eugenia Girda, MD, FACOG

The SGO Clinical Practice Committee recently published, “Cervical cancer treatment update: A Society of Gynecologic Oncology clinical practice statement.”  The document highlights cervical cancer mortality rates, associated financial toxicities, and novel therapeutic approaches for treating the disease. The practice statement appears in the November issue of Gynecologic Oncology. 

Cervical cancer, although one of the most preventable gynecologic malignancies, continues to pose a significant threat to women’s health globally, especially in low- and middle-income countries where it ranks as the second-highest cause of cancer mortality. Authors Eugenia Girda, MD, and Róisín O’Cearbhaill, MD, suggest that improving accessibility to screening and treatment are critical preventive measures.  

“Education is key, including outreach, community and school-based programs, and targeted vaccination clinics to increase awareness of HPV and screening for cervical cancer,” says Dr. O’Cearbhaill. Concerted efforts to ensure that patients are aware of cervical cancer symptoms, available resources, and the need for ongoing follow-up in the event of abnormal screening results, are also needed. 

Roisin E. O’Cearbhaill, MD

The practice statement highlights immunotherapy as one of the most promising avenues for cervical cancer treatment, particularly when administered early in the disease course. “It has a different side effect profile compared to traditional chemotherapy and may be better tolerated,” says Dr. O’Cearbhaill. Though studies are ongoing to identify patients most likely to benefit from immunotherapy, the specific combination of pembrolizumab with chemotherapy demonstrates a significant reduction in the risk of death among patients with recurrent and/or metastatic cervical cancer.  

This statement also addresses financial toxicity associated with cervical cancer, which can impact both physical and cancer-related outcomes. “The first steps are identifying patients with financial toxicity and assisting them with financial navigation,” says Dr. Girda. “Secondly, clinicians are encouraged to be mindful of the costs associated with multi-drug regimens and their relative benefits, as well as using biosimilar or generic medications, whenever feasible.”   Reducing geographic barriers to treatment centers is another recommendation for addressing inequities in cervical cancer care. 

Underrepresentation of racial and ethnic minorities in gynecologic oncology clinical trials is also a significant barrier to equitable treatment and care. The practice statement highlights the need for focused initiatives to alleviate clinical trial disparities. “Proposed strategies include adequate training of research staff, use of culturally appropriate information and language for counseling and consenting and setting enrollment goals for underrepresented racial and ethnic participants,” says Dr. Girda. 

The SGO Clinical Practice Committee will continue to guide members as the cervical cancer treatment landscape evolves with new, practice-changing data.