Cervical cancer: initial results from a European study
Recherche Clinique à l'Institut Curie. Dr Suzy SCHOLL, oncologue médical. La recherche clinique désigne l’ensemble des recherches médicales menées sur l’être humain. Elle a pour objectif de faire…
In Europe, 34 000 women are diagnosed very year with cervical cancer. Furthermore, the frequency is higher in Eastern countries due to the very recent deployment of screening. Another gap to fill: the absence of valid markers to predict the individual risk of relapse and select a more suitable targeted treatment, even though the origin of this cancer - infection by the papillomavirus (HPV) - is known.
"The RAIDs trial, the first European trial on cervical cancers, was designed to answer these issues. In fact, RAIDs includes several clinical trials covering the diagnostic, treatment and cognitive aspects", explains the coordinator, Dr Suzy Scholl of Institut Curie. "The RAIDs project is an international, multi-disciplinary collaboration between university hospitals, small and medium enterprises and translational research platforms in seven European countries: Germany, the Netherlands, Serbia, Moldavia, Romania, Hungary and France."
BioRAIDs: identification of biomarkers
While the first patient was signed up in October 2013 at Institut Curie coordinating the BioRAIDs sub-project, today 315 patients out of a planned 500 have been signed up. The trial aims to identify stratification markers in patients according to their genetic anomalies. The first 48 patient tumours have already been analysed in detail, and around fifty are currently being analysed bioinformatically. "Studying these data reveal a provisional list of altered genes in cervical cancer", explains the bioinformatician Philippe Hupé, CNRS research engineer at Institut Curie. This is a first step in offering new diagnostic tools and discovering more pertinent targeted treatments.
Standardise and innovate
Thanks to radiotherapy workshops organised for 14 consortium members, the various practices in European centres were compared and standardised, for the ultimate benefit of patients suffering from this gynaecological cancer.
As regards immunotherapy, the clinical trial coordinated by Prof. Gemma Kenter, gynaecological oncologist at NKI in Amsterdam ( Netherlands), assessed the effectiveness of a vaccine against the human papillomavirus (HPV) of type 16. While the results were not exactly encouraging, a new clinical trial is already being envisaged with a vaccine, still targeting HPV 16, but more effective with a different spectrum of action.
The biological analysis of twenty or so cell lines from cervical cancers confirmed the major role of the signalling pathway of an enzyme, PI-3K (phosphoinositide kinase) in tumour development. This avenue should continue to be explored as it may enable resistances to certain treatments to be understood and new therapies to be offered. Studies based on cell lines and animal models are also underway.
"The avenues being explored are numerous and varied", explains Maud Kamal, scientific project manager for RAIDs. "Thanks to this collective research effort, new biomarkers, and even one or more new targeted treatments should come to light", says Suzy Scholl.