子宮頸癌與標靶治療（精準醫學）

Cervical cancer and targeted therapy (Precision medicine)

子宮頸癌是全世界女性中第三常見的癌症，每年全球接近527,600名婦女得此疾病，年死亡人數為275,000人。目前已知人類乳頭狀瘤病毒是子宮頸癌的主要成因（超過99%的關聯性），因而預防接種人類乳頭狀瘤病毒疫苗可達到超過80-90%預防的效果。台灣由於子宮頸抹片普及多年，且引進接種疫苗約十年，使得子宮頸癌的發生率已從1990到1995年女性排行榜的第一，下降1995到2006年的第三，以及2014年的第八名。然而，晚期，復發，或已有轉移的子宮頸癌的預後仍然很差。傳統以同步化學放射治療治療。其後多年治療的演進卻乏善可陳。直到最近，從2014年以來，多項新療法方有亮麗成果的展現。一項用綜合式化療加上血管內皮生長因子的抑制劑（單株抗體bevacizumab）的治療，有效地增加整體存活率，是治療上的重要突破。未來因癌細胞分子途徑的更深入瞭解，針對特定分子加強或抑制的療法必成為這類病人治療的主流，許多新的治療，包含免疫療法、免疫檢查點抑制劑療法都呈現突破之勢。 Cervical cancer is the third common female cancer in the world, with 526,600 diagnosed cases, contributing to 275,000 deaths. Human papilloma virus (HPV) is the key factor to develop the cervical cancer (more than 99%). Therefore, HPV vaccination might prevent near 80%~90% of development of new cases. Papanicolaou smear and HPV vaccination significantly decreases the incidence of cervical cancer from the number 1 female cancer between 1990 and 1995 to the number 8 female cancer in 2014. However, the prognosis is still poor in the patients with advanced and recurrent cervical cancers. Concurrent chemoradiation is a gold standard therapy for those patients, but the therapy outcome still needs improvement. Many new approaches have been available since 2014, including bevacizumab, immunotherapy, and immune checking-point inhibitors. The current article focuses on the newly advanced therapy for the cervical cancer.