Medroxyprogesterone acetate found to be a promising treatment option for preventing and treating cervical cancer.
Cervical cancer remains a concern worldwide as this type of cancer is the third most common and third most deadly out of all the others. Human papillomavirus (HPV) can lead to cervical intraepithelial neoplasia (CIN), which are precancerous lesions that develop in the cervix, and if left untreated can lead to cervical cancer.
Researchers at the University of Houston investigated whether the drug medroxyprogesterone acetate (MPA) could be used as a potential treatment for cervical cancer. The results of their study were published in The American Journal of Pathology. Mice engineered to express HPV genes were first all treated with estradiol – a type of estrogen – in order to develop CIN lesions The mice with CIN lesions were then further treated with either just estradiol or a combination of estradiol and MPA, for varying amounts of time, to test the effect of treatment and lack of treatment on the lesions.
The mice that were treated with estradiol went on to develop cervical cancer, whereas the mice that were treated with a combination of estradiol and MPA did not develop cervical cancer. The researchers created two different groups of mice that were to receive MPA treatment, there was a long-term prevention group and a short-term prevention group. The long-term prevention group received a combination of estradiol and MPA treatment for three months, while the short-term prevention group received estradiol and MPA treatment for one month and then just estradiol treatment for an additional two months. It was seen that the long-term prevention group did not get cervical cancer and in addition, the MPA treatment was able to revert existing CIN lesions back to less developed states. On the other hand, some mice in the short-term prevention group did go on to develop cervical cancer. However, it was seen that even one month of treatment with MPA was able to reduce the severity of existing lesions. Even though there were still some cases of cervical cancer that developed in the short-term prevention group, the overall proportion of mice that had cervical cancer was still lower than in the group that received no MPA treatment. The way that MPA was able to stop the development of cervical cancer was by first encouraging the death of abnormally functioning cells and then also by preventing the multiplication of abnormal cells.
The mice with HPV were further classified based on their progesterone-receptor status as either progesterone-receptor positive or progesterone-receptor negative. The researchers found that almost half of the progesterone-receptor negative mice that were treated with MPA went on to develop cervical cancer. This led to the idea that the progesterone-receptor must be a major mediating factor in the effectiveness of MPA as a treatment strategy for cervical cancer.
Overall the data suggest that MPA is an effective cervical cancer treatment strategy for CIN lesions that are progesterone-receptor positive. Further research is required to determine if the results can be replicated in human clinical trials, as well as to determine how long MPA should be administered for favourable outcomes. There has also been some concern about MPA use leading to vaginal/cervical atrophy, which was not noted in this study but should be examined in future research. Any additional factors that would maximize the effectiveness of MPA treatment should also be determined in further studies.
Written by Haritha Thevar, BSc
References:
Baik, S., Mehta, F., & Chung, S. (2019). Medroxyprogesterone Acetate Prevention of Cervical Cancer through Progesterone Receptor in a Human Papillomavirus Transgenic Mouse Model. The American Journal Of Pathology. doi: 10.1016/j.ajpath.2019.08.013
Contraceptive drug shows promise for preventing and regressing cervical cancer. (2019). Retrieved 16 November 2019, from https://www.eurekalert.org/pub_releases/2019-11/e-cds110819.php
Estradiol: Side Effects, Dosages, Treatment, Interactions, Warnings. (2019). Retrieved 16 November 2019, from https://www.rxlist.com/consumer_estradiol/drugs-condition.htm
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