International Journal of Clinical Case Reports, 2025, Vol.15, No.3, 139-147 http://medscipublisher.com/index.php/ijccr 140 Because of this, doctors are now trying to mix targeted drugs with chemo. These two types of treatment work in different ways. Chemo kills fast-growing cells. Targeted drugs block the cancer’s growth signals. When used together, they may do a better job and help stop resistance (Yao et al., 2022). This study aims to find out how this mix of treatments helps people with cervical cancer. It will look at whether it is safe, how good it is at fighting cancer, and how it works inside the body. The purpose is to help patients live longer, feel more comfortable, and reduce deaths caused by cervical cancer. 2 Mechanisms of Action in Targeted and Chemotherapeutic Agents 2.1 Targeted therapy in cervical cancer Targeted therapy helps treat cervical cancer by stopping certain signals that help cancer cells grow and live. It also blocks the tumor from making new blood vessels and from hiding from the immune system. These drugs go after specific things found in cervical cancer cells. 2.1.1 Molecular targets One key target is a protein called VEGF. It helps tumors build new blood vessels. These vessels bring the tumor oxygen and food. When VEGF is too high, cancer grows faster and spreads. Blocking VEGF can slow the cancer down by cutting off its blood supply (Yao et al., 2022). Another important target is EGFR. Over half of cervical cancer cases show high EGFR levels. EGFR helps the cancer grow and keeps it from dying. Blocking EGFR can stop cancer cells from dividing and make them die (Pimple and Mishra, 2022). Some tumors use the PD-1/PD-L1 path to avoid being attacked by the immune system. When PD-L1 is high, the immune system can’t fight the tumor well. Drugs that block this path can help the immune system fight the cancer again (Wu et al., 2024). 2.1.2 Key targeted agents Bevacizumab is a monoclonal antibody targeting VEGF. In the landmark GOG-240 trial, the addition of bevacizumab to cisplatin/paclitaxel improved overall survival from 13.3 months to 17 months in patients with advanced cervical cancer, with a manageable safety profile (Tewari et al., 2014). Pembrolizumab is a PD-1 blocker. It works well for people whose tumors have PD-L1. In the KEYNOTE-158 study, 14.3% of patients got a good response. Some stayed better for a long time (Yuan et al., 2022). Nivolumab is another PD-1 drug. In one trial, it helped 26.3% of patients with advanced cervical cancer. It also delayed the cancer’s growth for around 5.1 months (Zhang et al., 2024). Erlotinib is a drug that blocks EGFR. It showed good results when used with other treatments in people whose cancer came back (Pimple and Mishra, 2022). 2.2 Chemotherapy Chemotherapy is still one of the main ways to treat cervical cancer. It is often used when the cancer is advanced or comes back. These drugs work by hurting the cancer’s DNA or stopping the cells from dividing. 2.2.1 Mechanisms and Common Agents Cisplatin is a common chemo drug. It damages the cancer cell’s DNA and causes the cell to die. Doctors often give cisplatin with radiation. Studies say that this combo helps people live longer. It may raise the 5-year survival rate by up to 12% compared to radiation alone (Figure 1) (Tiwari et al., 2018). As microtubule-stabilizing agent, paclitaxel prevents the breakdown of the mitotic spindle during cell division, causing mitotic arrest and apoptosis. In combination with cisplatin or carboplatin, paclitaxel improves response rates and overall survival in advanced cervical cancer (Arbyn et al., 2019).
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