Gynecological Cancers - Niche opportunities in advanced disease

Cases of endometrial cancer are set to rise in developed countries due to an increase in risk factors such as obesity. In contrast, while incidence of cervical cancer is set to decrease in developed countries following the implementation of anti-HPV immunization with Merck & Co's Gardasil and GlaxoSmithKline's Cervarix, it will remain a major cause of cancer-related death in the developing world.

The advent of anti-HPV vaccines capable of preventing cervical cancer, Merck & Co's Gardasil and GlaxoSmithKline's Cervarix, represent a major breakthrough, capable of significantly reducing the burden of disease. However, maximal impact will depend on the ease by which cash-strapped developing countries are able to gain access to these vaccines.

Despite being the most common of the gynecological malignancies, drug development for endometrial cancer is minimal. Given the high rate of early diagnosis and cure, the development of systemic therapies for metastatic disease has not been prioritized. This relatively inactive pipeline may become more of an issue as disease incidence increases.

While ample Phase I/II clinical trial data has been reported for the gynecological malignancies, only a small number of Phase III studies have been completed to corroborate earlier results. To fully define treatment strategies and provide solid evidence for clinical decision making, more large-scale, randomized clinical trials are necessary.

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