A DRUG that has been "revolutionary" in the treatment of melanoma has now been approved for use in cervical cancer in Australia.
Immuno-oncology therapy Keytruda - or pembrolizumab - has been listed on the Australian Register of Therapeutic Goods (ARTG) for the treatment of patients with persistent, recurrent, or metastatic cervical cancer.
Dr Janine Lombard, a medical oncologist at the Calvary Mater Newcastle, said cancer cells have a "clever way" of avoiding our immune system.
"This drug basically takes a roadblock out of that system, and allows the immune system to actually see the tumour and then enhance our body's own immune system to basically fight the cancer - or switch off the cancer cells - and drive them down a death pathway," Dr Lombard said.
Cervical cancer is a "very rare" cancer in the developed world, largely thanks to an "amazing" screening program and an effective vaccine, Dr Lombard said.
"In Australia, it is one of the more rare tumours that we see," she said.
"But it is a disease that has a very high burden on patients. So it gives a lot of horrible symptoms, and the treatment can be very difficult for people to navigate. It tends to be found in younger women, and it is over-represented in disadvantaged communities."
Access to the drug for people with recurrent cervical cancer was previously limited to clinical trials, but now it has been approved by the TGA, it can be prescribed to patients - although it is yet to be listed on the PBS.
Dr Lombard explained that in a large study of Keytruda, all women with relapsed cervical cancer were given chemotherapy, and then half of the participants received the immunotherapy drug too.
"What that study showed was that there was an improvement in the shrinkage of the cancer, the durability of control of the cancer," Dr Lombard said. "Most importantly, at the two-year mark - what we call overall survival at 24 months - there was an increase of roughly 10 per cent of you being alive at two years if you received the Keytruda. There has been very, very few advances in cervical cancer, and we have had pretty much nothing to improve outcomes in the past decade.
"So it is actually quite a big thing to find a drug which appears to make a 10 per cent improvement in survival at two years. The study is still immature - so we don't know what the overall survival will be later on. But certainly the provisional data is encouraging."
More than 70 per cent of cervical cancers have occurred in women who had never screened, or who were lapsed screeners. Mortality rates are almost three times higher in indigenous women, and women diagnosed with metastatic cervical cancer face a poor prognosis.
Dr Lombard encouraged women to continue being screened for cervical cancer.
"We have an excellent screening program in Australia, and we also have an excellent vaccination program," she said. "That has really, really changed this disease in countries where those programs are set up."
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