Side Effects From Newer Cervical Cancer Treatments May Seem ‘Daunting’ for Some Patients, But ‘We Will Have a Plan,’ Expert Says

With newer treatments like Keytruda (pembrolizumab) approved for patients with cervical cancer, a younger patient population may be concerned about experiencing side effects that interrupt their lives — but if they occur, clinicians will be ready with a plan for management, says an expert from the Uniformed Services University of the Health Sciences.

When being given a new treatment for their disease, many patients with cancer may ask questions like, “Will it work?” and “Will I have side effects?” For those with cervical cancer, a disease type that has recently seen new treatments approved in the space, those drugs may be daunting for a younger population that does not want to deal with side effects that impact their quality of life.

For patients who have recurrent or metastatic cervical cancer that cannot be treated with surgery or localized radiation, PD-L1 testing may help decide what the appropriate first-line treatment regimen is. While chemotherapy and Avastin (bevacizumab) are still mainstays, this testing may help providers decide whether Keytruda (pembrolizumab) may be a fit for patients.

In an interview with CURE®’s sister publication, OncLive, Dr. Yovanni Casablanca explained the typical concerns of patients with cervical cancer and why they should feel hopeful and excited about the new treatments that are entering the field.

“When you show (patients) or talk to them about the data and show them the incremental improvement in survival that these regimens are able to achieve and what the science has been able to achieve, that we've been able, in a period of a few years, (to) increase survival by 50%. And when you look at decades before (it doubles) it, I think that is really exciting to patients,” said Casablanca, who is a colonel in the Air Force and program director of the Fellowship in Gynecologic Oncology at the National Capital Consortium, as well as an associate professor in the Department of Gynecologic Surgery and Obstetrics at the Uniformed Services University of Health Sciences in Bethesda, Maryland.

However, some patients may still be apprehensive about taking a new treatment that could inundate their daily routine with debilitating side effects. Casablanca reassured those patients who may still be cautious.

“We do have pretty robust tools for management of these toxicities that have already been laid out through the foundation of using these drugs in other regimens and in other diseases before,” she said. “So, I just tell the patients that there is no side effect-free option, but it is (important) for us to let you know what you might need to expect — not that you're going to get all the side effects all at the same time, and who knows, yours might be milder than others, but if they're not, we will have a plan.”

Transcription:

Patients are very concerned about toxicity. And when you look at the studies using these new drugs, toxicity is quite common. And the way that I approach that with patients is I tell them, “Don't worry, we have a plan for this, most of the toxicities are going to be mild or moderate. Most of the time, we can modify the treatment; most of the time, we can do an adjustment to help mitigate this — we're not going to let this go unnoticed. We're going to address this in a proactive way.”

And really, we do have pretty robust tools for management of these toxicities that have already been laid out through the foundation of using these drugs in other ways and in other diseases before. So I just tell the patients that there is no side effect-free option, but it is (important) for us to let you know what you might need to expect — not that you're going to get all the side effects all at the same time, and who knows, yours might be milder than others, but if they're not, we will have a plan.

I think patients particularly this young population of cervical cancer patients, with average age about in their early 50s, I think even though it can be daunting, a little scary to think about new drugs with these toxicities. When you show them or talk to them about the data and show them the incremental improvement in survival that these regimens are able to achieve and what the science has been able to achieve, that we've been able, in a period of a few years, (to) increase survival by 50%. And when you look at decades before (it doubles) it, I think that is really exciting to patients.

And ultimately, when you have a cancer patient, one of the biggest questions they have in their mind is, “How long do I have? Am I going to die of this? What's my timeline?” And these new regimens are adding months and months of time and extending that overall survival in such a significant way that I think patients will be excited about that.

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