June 3, 2013 | by Hiu Chung So
The American Society of Clinical Oncology (ASCO) annual meeting in Chicago, May 31 through June 4, showcased two landmark studies about cervical cancer. One analyzed the effectiveness of a low-cost screening method in developing countries; the other found that the drug Avastin may benefit women with advanced disease.
Vinegar could be used as a screening tool The screening study followed 150,000 women in India from 1998 to 2010. The participants, ages 35 to 64 with no previous history of cancer, were randomized into two groups. One group received screening every two years with acetic acid (vinegar); and one group received no screening, the current standard of care. Participants in the second group were simply educated about the disease and asked to report any cervical cancer symptoms. In the screening group, young women were trained to apply the vinegar to the cervix of participants and assess the results.
As CNN Health reported: "Within just one minute, the person administering the test – using the naked eye and a light – can see if there are abnormal cells on the surface of the cervix; abnormal cells turn white, because the acid in the vinegar makes protein in the nucleus of the abnormal cells coagulate and become easily visible."At the conference, the scientists reported that, although both groups of women had comparable cervical cancer incidences, the vinegar-screened group had a 31 percent reduction in deaths linked to cervical cancer. This was due to the regular screenings' ability to catch the disease in earlier, more treatable stages.
Further, because the vinegar method is affordable and easy to perform, it could be widely implemented in developing countries that do not have the resources of infrastructure for a large-scale Pap smear or HPV (human papillomavirus) screening program. "The screening study ... is an excellent move forward in the ability in the third-world and developing countries to make an earlier diagnosis of cervical cancer such that there will be less deaths from that illness," said Robert Morgan, M.D., co-director of City of Hope's Gynecological Oncology/Peritoneal Malignancy Program, commenting about the study in the video above. The researchers reported that a global implementation of this program could prevent up to 72,600 cervical cancer deaths in developing countries each year.
Adding Avastin to cervical cancer treatment The other pivotal research presented at ASCO assessed the impact of adding bevacizumab (Avastin) to standard treatment for advanced cervical cancer. In this phase III clinical trial, 452 patients with recurrent or metastatic disease were randomized in four groups receiving either cisplatin+paciltaxel or topotecan+paciltaxel regimens, with or without bevacizumab. Although there were no significant differences between the two regimens, the scientists found that groups with bevacizumab survived almost four months longer (17 versus 13.3 months) than women who didn't receive the drug. Further, tumor shrinkage rates were higher in the bevacizumab groups (48 versus 36 percent), compared to the other group. In the video above, Morgan said these encouraging results could change treatment standards for this aggressive disease. "Metastatic cervical cancers are very difficult diseases to treat, because [they tend] to be resistant to chemotherapy [and they tend] to have an early development of resistance [to existing therapies]. The fact that we can now document that there is an improvement in survival using bevacizumab is a very important improvement in the treatment of these patients," Morgan said. The findings could lead to the Food and Drug Administration's first-ever approval of bevacizumab for a gynecological cancer; the drug is currently approved for colorectal, brain, lung and kidney cancers.