Recent advances in photodynamic therapy combined with chemotherapy for cervical cancer: a systematic review

ABSTRACT

Introduction

Despite the evidence that photodynamic therapy (PDT) associated with chemotherapy presents great potential to overcome the limitations of monotherapy, little is known about the current status of this combination against cervical cancer. This systematic review aimed to address the currently available advances in combining PDT and chemotherapy in different research models and clinical trials of cervical cancer.

Methods

We conducted a systematic review based on PRISMA Statement and Open Science Framework review protocol using PubMed, Web of Science, Embase, Scopus, LILACS, and Cochrane databases. We selected original articles focusing on ‘Uterine Cervical Neoplasms’ and ‘Photochemotherapy and Chemotherapy’ published in the last 10 years. The risk of bias in the studies was assessed using the CONSORT and SYRCLE tools.

Results

Twenty-three original articles were included, focusing on HeLa cells, derived from endocervical adenocarcinoma and on combinations of several chemotherapeutics. Most of the combinations used modern drug delivery systems for improved simultaneous delivery and presented promising results with increased cytotoxicity compared to monotherapy.

Conclusion

Despite the scarcity of animal studies and the absence of clinical studies, the combination of chemotherapy with PDT presents a potential option for cervical cancer therapy requiring additional studies.

OSF registration

https://doi.org/10.17605/OSF.IO/WPHN5

KEYWORDS:

• Uterine cervical neoplasms
• drug combinations
• photochemotherapy
• synergistic effect
• chemotherapy

Article highlights

• Photodynamic therapy (PDT) associated with chemotherapy presents great potential to cervical câncer treatment.

• Combination of chemotherapy agents with PDT for the cervical cancer has shown promise in preclinical in vitro and in vivo models.

• There is a lack of robust preclinical and clinical studies with the combination of chemotherapy agents with PDT targeting squamous cell cervical cancer.

• Efforts to progress the researchs with the combination of chemotherapy agents with PDT to the clinical stage and truly contribute to cervical cancer control.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

LR Carobeli: Conceptualization, Methodology, Data collection, Data analysis, Writing- reviewing and editing. ABC Santos: Methodology, Data collection, Writing- reviewing and editing. LBM Martins: Methodology, Data collection, Writing- reviewing and editing. E Damke: Data analysis, Writing- reviewing and editing. MEL Consolaro: Conceptualization, Funding acquisition, Data analysis, Writing- reviewing and editing.

Data availability statement

The authors confirm that the data supporting the findings of this study are available within the article and its supplementary materials. The databases generated during and/or analyzed during the current study are available from the corresponding author upon reasonable request.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/14737140.2024.2337259

Additional information

Funding

This study was funded by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)/Brazil – Fellowships.