Cervical cancer is the fourth most common type of cancer and the fourth leading cause of death in women. The year 2018 reported approximately 570 000 cases of cervical cancer. And 311 000 women died from the tumor.
A significant increase in the incidence of cervical cancer can be attributed to increasing cases of HIV infections in women, which has rendered women at a higher risk of developing pre-invasive cervical lesions, better diagnosis due to effective screening tests, and heightened awareness in developed nations.
Beyond the shadow of a doubt, advanced research has augmented the sensitivity of screening tests and HPV vaccines have majorly contributed towards obviating the emergence of HPV infection, yet cervical cancer continues to pose a global healthcare burden. The lack of timely diagnosis due to inadequate disease awareness, and seldom distinct symptoms aid to the process of metastasization of cancer.
In nearly 10-15% of the cases, by the time cervical cancer is diagnosed, cancer has already progressed to advanced stages. While the 5-year survival rate in the case of localized cervical cancer is more than 90%, the fate of the patients with hematogenous metastatic cervical cancer is grim with a 5-year survival rate below 20%.
The treatment of cervical cancers is based on the progression of the tumor. It is a complex process, and often physicians employ a multidisciplinary approach to treat the tumor. The treatment landscape of cervical cancer comprises surgical resection, radiation, chemotherapy, or a combination of these therapies. Radical hysterectomy performed with surgery has been a gold standard of the treatment for the last few years for early-stage (stage IA-IB1) patients. For locally advanced cancers (stage IIB2-IVA), primary chemoradiation or CCRT is a preferred treatment approach. For cancers that have metastasized, palliative care is the priority, and systemic treatment is a suitable option.
However, recently these approaches have come under scrutiny. Most patients put under the regimen experience recurrence. The inability to combat the recurrence of cancer adds to the cost of the treatment, leaving patients as well as caretakers in a state of quandary. Further, the treatments have a long-term relationship with adverse toxicities such as radiocystitis, radiation enterocolitis, vaginal stenosis, and pelvic adhesion.
Therefore, several pharma companies are proactively exploring novel treatment options to treat cervical cancer. Key companies such as Regeneron, AstraZeneca, Iovance, Zeria Pharmaceutical, Seattle Genetics/Genmab are actively engaged in accelerating the cervical cancer market size. The firms are evaluating their contenders at different stages of clinical development. Besides, some of the companies exploiting their candidates at earlier stages of development include Agenus Bio, Roche, Akeso Biopharma, and Vaccibody/Roche. The companies are investing in novel therapeutic agents as well as exploring the exiting treatment modalities to add their own charm.
What the future holds for Cervical Cancer Market?
Before digging into the cervical cancer drug pipeline, here, the addition of Avastin (bevacizumab) – targeted therapy – to the armamentarium is worth reckoning. It is augured as one the most, or say, the only notable advancement made in the cervical cancer treatment market for recurrent and metastatic cases. Roche’s recombinant humanized monoclonal IgG1 antibody, Avastin is approved for several cancers including recurrent or late-stage (metastatic) cervical cancer. The drug has enjoyed the monopoly in the cervical cancer market for years. However, as Avastin’s period of market exclusivity ended in 2019 in the US, the market witnessed heavy pouring of biosimilars. Pfizer’s Zirabev, Amgen’s Mvasi, and Samsung’s Aybintio are among the copy versions of Avastin approved for cervical cancer. The companies are also eyeing the European cervical cancer market, however, Avastin still has a few years to spare.
Another advancement shaping the recurrent/metastatic cervical cancer market in the foreseeable future is Immunotherapy. Merck’s Keytruda (Pembrolizumab) is also approved for advanced cervical cancer for PD-L1 positive patients. Keytruda is a leading man of the company, taking leaps and bounds in the field of cancer. Keytruda is indicated for several other cancers, last year, it managed to score seven approvals, and it looks likes many are on the way. However, the journey for the therapy will no be free of obstacles, as it will soon be wrestling with Regeneron’s Libtayo (Cemiplimab) for the cervical cancer market share. Libtayo is in the Phase III trial of development in the drug pipeline cervical cancer. AstraZeneca’s Imfinzi is also in the race with its drug Imfinzi (Durvalumab). The therapy is in the Phase III trial under evaluation in concurrence with chemoradiation therapy (SOC CCRT) and brachytherapy. Another player worth a mention here is Iovance Biotherapeutics. The company is investigating its tumor-infiltrating lymphocyte (TIL) therapy, LN-145, in cervical cancer patients. Although the trial is in early Phase II, the results look very promising, and if everything down the track goes smooth, it can be a great addition to the cervical cancer market.
While several companies are putting their faith in targeted therapies and immunotherapies, Genmab and Seattle Genetics preluded a bright future for its antibody-drug conjugate (ADC) therapy, Tisotumab vedotin. Recently, the duo announced positive topline result from Phase II single-arm clinical trial InnovaTV 204 investigating its drug relapsed or progressed on or after prior treatment for recurrent or metastatic cervical cancer.
Inovio Pharmaceuticals is also investing in the Cervical cancer market; however, the firm took off the beaten track, aiming for therapeutic cancer vaccines. Recently, the company presented with some impressive results from an open-label Phase 2 trial investigating its investigational immunotherapy vaccine, VGX-3100.
Overall, the clinical trials ongoing in the cervical cancer market have made headway in patients’ outcomes. Recent progress in the technology has not only facilitated better molecular alterations of cervical cancer but has opened a gate for novel therapeutic agents to advance the cervical cancer pipeline. Emerging immunotherapies targeted therapies, and vaccines as monotherapy or in concomitance with chemos shall improve the therapeutic value and add to the cervical cancer treatment landscape. Albeit, the cervical cancer market growth will experience a few roadblocks in the form of nuanced gendered perceptions, stigma, lack of awareness, and delayed diagnosis; even then, cervical cancer market growth in the coming decade looks quite promising.