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    Impact of hypoxia on cervical cancer outcomes

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    Authors
    Datta, Anubhav
    West, Catharine M L
    O'Connor, James P B
    Choudhury, Ananya
    Hoskin, Peter J
    Affiliation
    Division of Cancer Sciences, The University of Manchester Faculty of Biology Medicine and Health, Manchester, UK
    Issue Date
    2021
    
    Metadata
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    Abstract
    The annual global incidence of cervical cancer is approximately 604 000 cases/342 000 deaths, making it the fourth most common cancer in women. Cervical cancer is a major healthcare problem in low and middle income countries where 85% of new cases and deaths occur. Secondary prevention measures have reduced incidence and mortality in developed countries over the past 30 years, but cervical cancer remains a major cause of cancer deaths in women. For women who present with F�d�ration Internationale de Gyn�cologie et d'Obst�trique (FIGO 2018) stages IB3 or upwards, chemoradiation is the established treatment. Despite high rates of local control, overall survival is less than 50%, largely due to distant relapse. Reducing the health burden of cervical cancer requires greater individualization of treatment, identifying those at risk of relapse and progression for modified or intensified treatment. Hypoxia is a well known feature of solid tumors and an established therapeutic target. Low tumorous oxygenation increases the risk of local invasion, metastasis and treatment failure. While meta-analyses show benefit, many individual trials targeting hypoxia failed in part due to not selecting patients most likely to benefit. This review summarizes the available hypoxia-targeted strategies and identifies further research and new treatment paradigms needed to improve patient outcomes. The applications and limitations of hypoxia biomarkers for treatment selection and response monitoring are discussed. Finally, areas of greatest unmet clinical need are identified to measure and target hypoxia and therefore improve cervical cancer outcomes.
    Citation
    Datta A, West C, O�Connor JPB, Choudhury A, Hoskin P. Impact of hypoxia on cervical cancer outcomes. International Journal of Gynecologic Cancer. BMJ; 2021. p. ijgc�2021�002806.
    Journal
    International Journal of Gynecological Cancer
    URI
    http://hdl.handle.net/10541/624658
    DOI
    10.1136/ijgc-2021-002806
    PubMed ID
    34593564
    Additional Links
    https://dx.doi.org/10.1136/ijgc-2021-002806
    Type
    Article
    Language
    en
    ae974a485f413a2113503eed53cd6c53
    10.1136/ijgc-2021-002806
    Scopus Count
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