A game-changing approach for the treatment of early-stage cervical cancer

University researchers are pioneering a new topical treatment for cervical cancer and forming global partnerships to help more women in developing countries survive the disease.

Global challenge: costly cervical cancer screening and treatment

Globally, one woman dies every two minutes from cervical cancer – 85% of these deaths occur in developing nations. In Kenya, cervical cancer is the second most common cancer in women and is the most common cause of cancer deaths.

Cervical cancer is caused by infection with high-risk forms of the human papillomavirus (HPV), yet there is currently no treatment for HPV infection. Developed countries manage disease prevention through cervical screening, which is used to identify early-stage pre-cancerous lesions that are surgically removed at outpatient services.

Screening facilities in developing nations are costly and scarce, resulting in early-stage pre-cancerous cervical disease often being treated by a full hysterectomy. A low-cost alternative to cervical screening is needed for women in poorer nations and to help reduce the high disease burden.

We discovered that repurposing a drug used to treat HIV (lopinavir) would specifically kill cells infected with human papillomavirus, which cause virtually all cases of cervical cancer.

Ian Hampson / Professor of Viral Oncology

Manchester solution: thinking differently about drug repurposing

Innovative research led by The University of Manchester revealed the potential of lopinavir – a commonly-used HIV drug – to treat cervical cancer. Tests carried out on cell cultures indicated that repurposing the drug as a topical, self-applied treatment for early-stage HPV-related cervical disease could prove successful.

In collaboration with Canadian researchers, early lab tests showed that lopinavir selectively attacks the HPV-infected cells that cause cervical cancer and leaves healthy cells relatively unharmed.

The team predicted that the oral drug could be made into a simple cream or pessary to apply to the cervix. They were the first to report the activity of using lopinavir against HPV-positive cervical cancer cell lines, which identified this as the most promising candidate drug.

Dr Lynne Hampson, Reader in Viral Oncology, and Professor Ian Hampson, Research Lead and Professor of Viral Oncology, said: “We discovered a drug that could provide a simple, non-surgical treatment alternative for women with early-stage cervical cancer and were immediately excited about the life-changing improvements this could have for thousands of women in developing countries.”

“It could help improve access to treatment in countries that lack basic infrastructure, such as transport or access to expensive vaccines. We wanted to progress this as an effective and cheaper treatment option.”

Transforming outcomes for Kenyan women

The team ran a clinical trial in Kenya as part of their mission to help global populations benefit from discoveries made in Manchester. The treatment-focused trial involved 23 women with early-stage cervical cancer who received a soft-gelatine capsule, oral formulation of lopimune as a pessary for two weeks. The results showed that approximately 60% of the women returned to normal pathology and 19% regressed to low-grade disease within three months.

Professor Hampson says: “We found that the treatment had an obvious positive effect when it was used as a self-applied treatment, which was consistent with our earlier laboratory studies”.

The treatment is now being developed by Douglas Pharmaceuticals, a New Zealand-based manufacturer, to produce a bespoke formulation designed to treat the cervix. Clinical trials on this new product are expected to start in 2021.

Research impacts

The University of Manchester’s research has helped to:

  • establish a free cervical cancer screening and treatment service in Nairobi, with training provided by Manchester;
  • pioneer new treatment that, if successful at trial, will increase access to non-surgical treatment for early-stage cervical cancer and has the potential to save the lives of thousands of women diagnosed with the disease;
  • create a partnership with Douglas Pharmaceuticals to develop an optimised topical formulation – two additional patents have been filed for the drug;
  • build an investment partnership with Douglas Pharmaceuticals to fund formulation optimisation and a new proof of concept clinical trial in New Zealand;
  • secure a patent on this work, with licenses granted in the USA, Europe and Australia.

Meet the researchers