Targeted treatment options for the management of metastatic/persistent and recurrent cervical cancer

Cervical cancer is the overall fourth most common malignancy and the fourth most common cause of cancer-related deaths worldwide. Despite vaccination and screening programs, many women continue to present with advanced stage cervical cancer, wherein the treatment options have been limited.In this review, immunotherapy and the potential targeted therapies that have demonstrated promise in the treatment of persistent, recurrent, and metastatic cervical cancer are discussed.Our global goal in the gynecologic oncology community is to eliminate cervical cancer, by increasing the uptake of preventive vaccination and screening programs. For unfortunate patients who present with metastatic, persistent, and recurrent cervical cancer, pembrolizumab with chemotherapy, with or without bevacizumab is the new first-line therapy for PD-L1 positive patients. For this patient population as a second-line therapy, tisotumab vedotin (i.e. ADC) has shown significant efficacy in phase II trials, leading to the US Food and Drug Administration approval. Combination regimens inclusive of immune checkpoint inhibitors, DNA damage repair inhibitors, and antibody drug conjugates are potential breakthrough treatment strategies and are currently being investigated.