Cervical Cancer Flashcards
Most common HPV serotypes associated with cervical cancer?
16, 18, 31, 33
What is the recommended age range for HPV vaccination?
11-12. Catch-up vaccination between 13-26
Abnormal Pap smear but no visible lesion on cervix. What now?
Cervical conization/LEEP
Stage I cervical cancer is defined:
Confined to cervix
Stage II cervical cancer is defined:
Invades beyond uterus, but not extended onto the lower third of the vagina or to the pelvic wall
Stage III cervical cancer is defined:
-Involves lower third of vagina and/or
-Extends to pelvic wall and/or
-Causes hydronephrosis or non-functioning kidney and/or
-Involves pelvic and/or paraaortic LNs
Treatment for tumor confined to uterus and size <2 cm and <10mm stromal invasion
Simple hysterectomy
Treatment for Stage II-IVA cervical cancer
weekly Cisplatin+RT concurrent
Treatment for Stage IA1
Simple hysterectomy
Cervical conization to preserve fertility
Treatment for Stage IA2-IB2
Radical hysterectomy with lymphadenectomy or
Radical trachelectomy with lymphadenectomy to preserve fertility
Who should receive adjuvant chemoradiation? (3)
Positive surgical margins
Positive LNs
Parametrial involvement
At what tumor size (and above) do you recommend concurrent chemoRT?
4 cm
Indication for pelvic exenteration
Central recurrence in patient with previous radiation
SOC for metastatic/recurrent cervical cancer 1st line with PD-L1 CPS >1?
Platinum + Paclitaxel + Bev + Pembro
Indication for adding pembrolizumab to recurrent/metastatic cervical cancer regimen?
PD-L1 CPS >1
MoA of Tisutumab vedotin
Tissue factor ADC
2nd line treatment for recurrent/metastatic cervical cancer progerssed after chemotherapy? (3)
Tisutumab vedotin
Nivo (PD-L1 positive)
Pembro (PD-L1 positive or dMMR)
1st line treatment for recurrent/metastatic cervical cancer PD-L1 negative?
Cisplatin + Paclitaxel + Bev
What features make a patient more likely to respond to chemotherapy in recurrent/metastatic setting?
mets in a non-irradiated area
when cisplatin wasn’t used previously
long disease-free interval
What medication can be added to concurrent chemoRT in stage III-IVA cervical cancer?
Pembro
