Cervical cancer can be insidious. Changes to the cervix are often detected with a pap smear, but for those with limited access to health care, cervical and vaginal cancers can go unnoticed for years–silently growing, spreading and invading other organs. By the time they’re detected, they are already advanced (metastases in organs); the patient’s prognosis becomes poor and chances for life really few. Dr. Valerie Galvan Turner, a gynecologic oncologist at the West Virginia University Cancer Institute, has opened a randomized clinical trial to assess whether a novel supplemental treatment can help chemotherapy and radiation fight these dangerous forms of cancer better. Women newly diagnosed with stage IB2, II or IIIB-IVA cervical cancer, or stage II-IVA vaginal cancer, will be eligible for the study. This study, one of the few to include vaginal cancer, has been funded by the National Cancer Institute (NCI/NIH). Vaginal cancer is very rare. Most cases are related to metastatic cervical cancer or HPV infection. Smoking may increase the risk of cancer in that area and other risk factors are still poorly understood.
Participants will be randomly assigned to one of two groups. The first group will receive weekly chemotherapy with a course of radiation. The second group will be given the same treatment except for one difference: it will be given a drug named triapine. Triapine inhibits the production of DNA bases by blocking the enzyme RDPR. It works like the drug hydroxyurea, though this is more specific for blood and bone marrow malignant cells. Triapine sensitizes cancer cells to radiations and works with other DNA-targeting drugs like cisplatin, that is currently used for endometrial cancer. After participants undergo either the standard or experimental treatment, Dr. Turner and her team will monitor them for at least five years to determine which group has the lower rate of cancer progression. Imaging technologies like CT and combined PET/CT scans will enable her to track the tumors as they grow, spread, shrink or disappear. Dr. Turner will also compare the overall survival rates between the two groups and observe whether the patients who took triapine were more likely to experience side effects.
Not only does the study’s inclusion of vaginal cancer set it apart, but it’s also noteworthy for involving patients diagnosed with cancer for the first time. Many cancer-treatment studies include only patients with refractory cancers, those that have returned after responding to an initial chemotherapy. Dr Turner is currently enrolling eligible patients in the study, along with her research partner Dr. Charles Leath, lead investigator at the University of Alabama at Birmingham. She precised: “That’s why this is a great trial to offer our patients here. Regardless of whether you’re assigned to the control group or the experimental group, you’re going to get the highest standard of care. There are many benefits to participating in a clinical trial. Not only do patients receive standard treatment with close follow-up during this time, they also have a dedicated team of research personnel and nurses to help them navigate through their treatment course. We want patients to know that WVU Medicine is on the forefront of advanced treatments and therapies when they think of cancer treatments and having access to leading clinical trials. Patients no longer have to leave the state to get the highest-quality care”.
- Edited by Dr. Gianfrancesco Cormaci, PhD, specialist in Clinical Biochemistry.
Lawton B, Howe AS et al. Vaccine 2018; 36(1):134-140.
Driedger SM et al. BMC Cancer 2017 Sep 13;17(1):647.
Dott. Gianfrancesco Cormaci
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