Immunotherapy: A New Strategy for the Treatment of Cervical Cancer. Interview with Dr. Christian Marth and Dr. Sharad Ghamande

At the European Gynecological Oncology Congress (ESGO) 2017, held in Vienna, a symposium on immunotherapy took place: A New Strategy for the Treatment of Cervical Cancer, sponsored by Advaxis, Inc.


Background
At the European Gynecological Oncology Congress (ESGO) 2017, held in Vienna, a symposium on immunotherapy took place: A New Strategy for the Treatment of Cervical Cancer, sponsored by Advaxis, Inc.
Dr. Christian Marth, the chair of the symposium, and Dr. Sharad Ghamande, a Gynecological Oncologist coordinating a clinical study of the immunotherapy drug axalimogene filolisbac, shared with us their views about the current state of immunotherapy in cervical cancer.

Short Biographies
Dr. Christian Marth is a professor in the Department of Obstetrics and Gynecology, Innsbruck Medical University, Austria, and the principal investigator for Advaxis' trial to treat metastatic cervical cancer patients. He got his medical degree from Innsbruck University in 1985. From 1985 to 1991 he did his training in obstetrics and gynecology at the Department of Obstetrics and Gynecology at the Innsbruck University Hospital. In 1991, he obtained his PhD in obstetrics and gynecology.

Dr. Christian Marth
Dr. Sharad Ghamande is currently Professor and Director of Gynecologic Oncology at the Georgia Cancer Center at Augusta University and a Principal Investigator for Advaxis. He is boardcertified in both obstetrics and gynecology and gynecologic oncology. Dr. Ghamande completed his fellowship in gynecologic oncology at Roswell Park Cancer Institute in Buffalo, New York in 2000. His residency in obstetrics and gynecology was completed at Boston Medical Center in Boston, Massachusetts.

Dr. Christian Marth
Dr. Sharad Ghamande is currently Professor and Director of Gynecologic Oncology at the Georgia Cancer Center at Augusta University and a Principal Investigator for Advaxis. He is board-certified in both obstetrics and gynecology and gynecologic oncology. Dr. Ghamande completed his fellowship in gynecologic oncology at Roswell Park Cancer Institute in Buffalo, New York in 2000. His residency in obstetrics and gynecology was completed at Boston Medical Center in Boston, Massachusetts.

Q1. In recent years, we have heard more and more about immunotherapy. Can you explain what it is and how it can be used to treat cancer?
R1. Immunotherapy is treatment that uses the immune system to fight diseases such as cancer. This can be done in different ways by stimulating the immune system to attack cancer cells. These cells have to be recognized as foreign and can then be killed by the immune cells. Different types of immunotherapy are used to treat cancer. They include: • Checkpoint inhibitors (these are monoclonal antibodies that block cancer cells' ability to inhibit the immune system) and • Treatment vaccines (which work against cancer by boosting the immune system and inducing a response against cancer cells).
Q2. As far as I know, there are experimental treatments based on immunotherapy for different types of cancers. How has the efficiency been so far?
R2. Immunotherapy drugs are now used to treat many different types of cancer. For advanced or metastatic melanoma, bladder cancer, kidney cancer, and lung cancer, immunotherapy has resulted in an outstanding improvement in the survival of treated patients. For the first time, it can be speculated that a therapy is able to cure metastatic cancer patients. For some indications, immunotherapy is already standard care. For others, it is still experimental.

Q3. Do you think immunotherapy can change cancer treatment in the short term?
R3. Immunotherapy is one of the most important achievements in oncology. For many-maybe not all-types of cancer, immunotherapy, in the short term, will be included in the frontline therapy and has the potential to increase the cure rate.

Q4. What is the state of the art of immunotherapy in gynecological cancers?
R4. In gynecologic malignancies immunotherapy is still experimental, although very promising. For a special subtype of endometrial cancer with so-called mismatch repair deficiency, checkpoint inhibitors have already been approved by the FDA. In other indications, such as ovarian cancer or cervical cancer, trials are ongoing. We will start a very innovative trial soon by using a modified bacterium to bring tumor antigens into the patient's body. These bacteria will be recognized by the immune system and, in an attempt to destroy them, tumors having the same antigens will be destroyed.

Q1. In recent years, we have heard more and more about immunotherapy. Can you explain what it is and how it can be used to treat cancer?
R1. Immunotherapy is treatment that uses the immune system to fight diseases such as cancer. This can be done in different ways by stimulating the immune system to attack cancer cells. These cells have to be recognized as foreign and can then be killed by the immune cells. Different types of immunotherapy are used to treat cancer. They include: • Checkpoint inhibitors (these are monoclonal antibodies that block cancer cells' ability to inhibit the immune system) and • Treatment vaccines (which work against cancer by boosting the immune system and inducing a response against cancer cells).
Q2. As far as I know, there are experimental treatments based on immunotherapy for different types of cancers. How has the efficiency been so far?
R2. Immunotherapy drugs are now used to treat many different types of cancer. For advanced or metastatic melanoma, bladder cancer, kidney cancer, and lung cancer, immunotherapy has resulted in an outstanding improvement in the survival of treated patients. For the first time, it can be speculated that a therapy is able to cure metastatic cancer patients. For some indications, immunotherapy is already standard care. For others, it is still experimental.

Q3. Do you think immunotherapy can change cancer treatment in the short term?
R3. Immunotherapy is one of the most important achievements in oncology. For many-maybe not all-types of cancer, immunotherapy, in the short term, will be included in the frontline therapy and has the potential to increase the cure rate.

Q4. What is the state of the art of immunotherapy in gynecological cancers?
R4. In gynecologic malignancies immunotherapy is still experimental, although very promising. For a special subtype of endometrial cancer with so-called mismatch repair deficiency, checkpoint inhibitors have already been approved by the FDA. In other indications, such as ovarian cancer or cervical cancer, trials are ongoing. We will start a very innovative trial soon by using a modified bacterium to bring tumor antigens into the patient's body. These bacteria will be recognized by the immune system and, in an attempt to destroy them, tumors having the same antigens will be destroyed.