The ring delivers the drug Disulfiram direct to the cervix in a controlled and sustained manner, potentially reducing the need for surgical intervention and providing a novel anti-cancer therapy for women.
Experts at the University of Wolverhampton, Queen’s University of Belfast and Athlone Institute of Technology in Ireland have published research into the development of the vaginal ring in the European Journal of Pharmaceutics and Biopharmaceutics.
Cervical cancer is the third most prevalent cancer in women globally, with 529,000 new cases diagnosed each year, 275,000 of which result in death.
Dr Chris McConville, Senior Lecturer in Pharmaceutics at the University’s School of Pharmacy, has developed a ring that delivers the chemotherapy drug Disulfiram locally to the cervix, with the potential to reduce side effects and improve the patient’s quality of life.
Dr McConville said: “The location of the cervix allows for non-invasive localised delivery of chemotherapeutic drugs directly to the cervix. This allows for a lower dose to be delivered and reduces the side effects when compared to administration through the bloodstream.
“This type of approach would not only be useful in fertility sparing treatment but also in general cervical cancer treatment, where it would allow for smaller cancers and thus bigger cancer free margins to be removed. Cancer free margins are areas of normal tissue surrounding the cancer where no cancer cells are present. The bigger the cancer free margin, the less chance there is any cancer cells left behind and thus the risk of the cancer returning is significantly reduced.”
The treatment of cervical cancer will depend on the type, stage grade of the cancer, as well as the woman’s general health and whether or not she would like to have children after treatment, particularly as more cases are occurring in women of child-bearing age.
Treatment usually involves a combination of surgery, chemotherapy and/or radiotherapy. In the case of chemo and radiotherapy, it can result in significant side effects, reducing the patient’s overall quality of life during the treatment.
In the UK, fertility sparing surgery is only offered to women who have early stage cervical cancer, which is less than 2cm in size, as any larger will reduce the size of cancer free margin to be removed which will significantly increase the risk of the cancer returning.
The vaginal ring has the potential to reduce the size of late stage cancers to less than 2cm, allowing for a much smaller cancer to be removed, significantly reducing the risk of the cancer returning. In fertility sparing surgery the removal of a small cancer is key, so as to allow for larger cancer free margins reducing the risk of recurrence, while not damaging the integrity of the cervix, reducing the risk of preterm birth.
Another vaginal ring could be put in place after surgery, to further reduce the risk of the cancer returning.
Dr McConville added: “One of the advantages of the Disulfiram vaginal ring is the fact that Disulfiram has been used in humans to treat alcohol dependency and therefore it is already known to be safe for humans to use. Also, the levels of Disulfiram needed to treat cervical cancer are much lower than those that are administered to treat alcohol dependency.”
Vaginal rings are also already on the market and used for hormone replacement therapy, and contraception and are currently being tested in the clinic for HIV prevention.
Further tests are now needed into the treatment, and funding is currently being sought to do the tests.
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