Therapeutic Interventions in Cervical Cancer

Despite advances in effective screening and prophylactic vaccination strategies, cervical cancer continues to pose a significant global public health challenge, particularly in low and middle-income countries. The principal etiological factor driving cervical carcinogenesis is the persistent infection with high-risk HPV subtypes, mainly HPV16 and HPV18. The oncogenic potential of HPV is mediated through the sustained expression of viral oncoproteins E6 and E7, resulting in disruption of key tumour suppressor pathways, induction of genomic instability, and malignant transformation. The diagnosis of cervical cancer will involve a multimodal approach, using cytological screening, testing for high-risk HPV, colposcopy-guided biopsy, and imaging-based staging systems that allow risk stratification and treatment planning. The therapeutic interventions are mainly stage-dependent, ranging from surgical management for early-stage disease to concurrent chemoradiotherapy for locally advanced cancer and systemic chemotherapy in cases of recurrent or metastatic disease. In the last decade, targeted therapies like antiangiogenic agents, immune checkpoint inhibitors, ADCs, epigenetic modulators, and experimental immunotherapeutic and gene-based approaches targeting virus-associated molecular pathways have expanded the therapeutic landscape. Despite these developments, clinical outcomes in advanced and recurrent cervical cancer continue to be suboptimal because of limited durable response rates and significant toxicity associated with treatments. .