Neoplasms

Urinary Tract, Sexual Organs, and Pregnancy Conditions

All Conditions

Rare Diseases

Uterine Cervical Dysplasia

Precancerous Conditions

Uterine Cervical Diseases

Uterine Diseases

Genital Diseases, Female

Genital Diseases

Urogenital Diseases

Female Urogenital Diseases

Pregnancy Complications

Female Urogenital Diseases and Pregnancy Complications

Cervical Intraepithelial Neoplasia

Healthy women 25 - 30 years of age with CIN2 who consent to inclusion and with no former history of CIN (any grade). The "intervention" is expectancy with clinical visits every 6 months. Women will leave study cohort if found with total regression (no CIN) or CIN3

Expectancy

Strander

In the Swedish organised cervical screening program precursors of cervical cancer are detected and treated. Most precursor lesions detected by screening heal spontaneously. Those who progress do it slowly. There are three levels from light; CIN1, moderate; CIN2 to severe; CIN3. Women with CIN3 are always treated, regardless of age, according to current clinical guidelines. Women with CIN2 who are below the age of 25 years are offered active expectance for up to two years because there is good evidence that they will spontaneously heal their lesions (regression) in 40-70% of the cases during that time.

Method of treatment is today an excisional procedure of the cervix most often by Large loop excision of the transformation zone (LLETZ/LEEP) Treatment increases the risk of premature birth in a future pregnancy. In 2015 about 1800 excisional procedures of the transformation zone of the cervix were performed in the Västra Götalands regionen (VGR) om Sweden. The average age of first-time mothers in Sweden is rising and in 2014 it was 29 years. Postponed childbearing raises the question whether it is possible to refrain from surgery even for the group of women over 25 years old, with proven CIN2. Existing studies suggest that cure of CIN2 in the age group of and above 25 takes place in the same extent as under 25 years of age.There is lack of evidence concerning clinical follow-up.

In a prospective multicenter clinical cohort study (observational study) with careful monitoring, the investigators will examine what proportion of CIN2 changes regress spontaneously within two years in women, 25-30 years old, and if human papillomavirus (HPV) type 16 may can be a marker for poor regression in this group. Instead of LLETZ, active expectance is offered to women this age with CIN2 in five gynecological clinics in VGR. The study protocol includes gynecologist visits every 6 months for two years, including cytology, colposcopy and directed biopsies of the cervix. Power calculation shows 160 women needs to be included, which is expected to occur within one year from the start.

Expectancy as Alternative to Treatment for Cervical Intraepithelial Neoplasia Grade 2 Among Women 25 - 30 Years of Age

Expectancy as Alternative to Treatment for Cervical Intraepithelial Neoplasia Grade 2 Among Women 25 - 30 Years of Age. A Multicenter Clinical Study

Proportion of women with CIN2 at inclusion who will regress to CIN1 or no evidence of disease

Proportion of women with CIN2 and HPV 16 at inclusion who will regress to CIN1 or no evidence of disease

Sahlgrenska University Hospital, Sweden

Senior researcher

Infections

Symptoms and General Pathology

Communicable Diseases

Papillomavirus Infections

Sexually Transmitted Diseases

Sexually Transmitted Diseases, Viral

Virus Diseases

DNA Virus Infections

Tumor Virus Infections

Disease Attributes

Pharmaceutical Solutions

All Drugs and Chemicals

Anti-Infective Agents

Other Dietary Supplements

Herbal and Botanical

Eugenol

Antiviral Agents

Olive

Drug: application of topical spray on the cervix one time (2 puffs) topical application of 100µl AV2 antiviral spray( natural essential oil components in equal volumes diluted 50% in olive oil)

Drug: application of topical spray on the cervix one time (2 puffs) topical spray of 100 µl on the cervix.

The virucide AV2 consists of a spray. It is a mixture of natural essential oil components (Carvone, Eugenol, Geraniol, Nerolidol) in equal volumes diluted 50% in olive oil (Olea europaea).

It is administered as a topical spray to the cervix while the subject is in the lithotomic position and fitted with a speculum. The manual spray applicator is positioned inside the anterior of the vagina and two pumps are applied. Each pump delivers 100 microliters of the solution.

The placebo consists of 10% lemon (citrus limon) and 10% lime (citrus aurantifolia) in 80% olive oil.

It is administered as a one time (2 puffs) topical spray of 100 microliters on the cervix.

Placebo

Yves Jacquemyn, MD PhD

Alex Mutombo Baleka, MD

1. Introduction Cervical cancer (CC) is a major public health problem in Low-income countries (LICs), particularly in the Democratic Republic of the Congo (DRC), where the estimated number of cases is 3839 per year. (WHO, 2010).

   Persistent infection with Human Papillomavirus (HPV) is recognized as the necessary cause for the development of CC. Thus, CC is a disease that is easily preventable primarily by vaccination against HPV and secondarily through screening and treatment of precancerous lesions of the cervix.

   In LICs, the high incidence of CC is due to both high rates of infection with HPV, a failure to initiate and sustain effective screening programs based on cytology and the non-availability of vaccination against HPV. These situations highlight the need to implement simple and inexpensive screening and treatment methods suitable for LICs. These methods include screening by visual inspection of the cervix after application of acetic acid (VIA) and treatment with a topical antiviral drug (AV2).
2. Aims

   This study aims to:
   * Evaluate the clinical efficacy of AV2 as a treatment for HPV-associated lesions of the uterine cervix;
   * Identify HPV genotypes found in Kinshasa;
   * Determine the cost-effectiveness of an algorithm combining screening by VIA and AV2 and that combining VIA and cryotherapy treatment;
3. Methods After basic training of local health workers on VIA, on collection of cervical samples for HPV testing (quantitative Polymerase Chain reaction, qPCR) and liquid-based cytology (LBC) and on application of AV2, a screening and treatment program will be offered to women aged 25 and older who will give their informed consent.

All women with lesions on VIA will be randomized into one of two groups to receive either treatment by AV2 or placebo.

All women with lesions on VIA will be monitored and reviewed after two months and after six months for repeat tests (VIA and LBC for lesions, qPCR for viral load, conversion and reinfection rates).

CHAPTER 1: INTRODUCTION 1.1. BACKGROUND Cervical cancer (CC) is the third most common cancer in women, and the seventh overall, with an estimated 530 000 new cases per year. More than 85% of the global burden occurs in low-income countries (LICs). It is responsible for 275 000 deaths per year, about 88% of which occurring in LICs. Overall, the mortality: incidence ratio is 52. (Ferlay et al, 2010).

The link between genital high-risk Human papillomavirus (HPV) infections and CC was first demonstrated in the early 1980s by Harold zur Hausen, a German virologist. (Gissmann, L et al, 1983) HPV infection may be transient or persistent. When it persists, HPV induces changes in cells of the cervix, precisely in the transformation zone. These changes constitute the precursor lesions of cervical cancer. These precursor lesions are either called precancerous lesions, dysplasia or cervical intraepithelial neoplasia (CIN). Left untreated, they can progress from mild (CIN1) to moderate (CIN 2) to severe (CIN 3) dysplasia, and then to cancer. It appears that dysplasia is asymptomatic and progresses to cancer over a prolonged period of time, usually 7 to 20 years.

CC is then a potentially preventable and curable cancer. It can be prevented by vaccination against HPV and by screening. The latter involves the detection and treatment of precursors lesions on asymptomatic women.

Several tests can be used for CC screening:

* Cytology (conventional or liquid-based) also called Pap test or Pap smear.
* Visual inspection of the cervix after application of 5% acetic acid or vinegar (VIA).
* HPV-DNA testing. In LIC, the method of screening with low-cost test such as VIA and treating women with positive result with such treatment as cryotherapy in one single visit is known as the "see-and-treat approach". This would minimize loss to follow up, delay in treatment and missed cases.

1.2 ISSUES In HICs, cytology has been introduced as a screening test and reduced markedly the incidence of CC.

In LICs such screening has not been feasible. The high incidence and high mortality for cervical cancer in LIC is due to both high rates of infection with high-risk HPV, a failure to initiate or sustain effective cervical cancer screening programs based on cytology and the non-availability of region-specific HPV vaccine programs.

For that reason, VIA and HPV testing have been recommended for LICs. VIA involves the naked eye inspection of the uterine cervix after application of 3 to 5 % acetic acid. Its sensitivity and negative predictive value are very high, reaching 95% in most of the studies (Sarian, 2005; Sankaranarayanan, 2004).

Only limited data are available on the prevalence and the distribution of HPV variants among women in the general population in DRC. Cytology has been proposed as a screening tool, but it's very opportunistic because there is no organized cervical cancer screening program based on it. On the other hand, most of the Congolese women, living on less than 1 dollar a day can't afford it. Vaccination against HPV infection has not been introduced yet in DRC. It holds promise for the prevention of cervical cancer, yet its impact will not be fully realized until many years after a vaccination program is instituted. To best understand the impact of large-scale vaccination programs, one must first appreciate baseline prevalence of HPV subtypes. Thus, secondary-level prevention i.e. screening is crucial.

Cryotherapy has been proposed as the way to choose for treating cervical precancerous lesions in low-resource settings but it is hampered by major logistic problems (such as availability of carbon dioxide or nitrous oxide); Thus, VIA for screening combined with a simple single treatment with a vaginal spray of AV2 might offer logistical advantages.

1.3 AIMS

Overall Aim:

To contribute to the amelioration of cervical cancer prevention in the Democratic Republic of Congo.

Specific aims:

1. To evaluate the clinical efficacy of the local AV2 antiviral drug in the treatment of HPV-associated cervical lesions.
2. To determine the genotypes of HPV found in the Kinshasa region.
3. To test the impact of HPV screening followed by virucide treatment in a see-and-treat setting on HPV infection and associated cervical lesions.
4. to model the cost-effectiveness of:

   * VIA screening test and virucide treatment algorithm
   * VIA screening test and cryotherapy treatment algorithm 1.4 Hypothesis - The viricidal spray is more effective than placebo in the treatment of HPV-associated cervical precancerous lesions.

CHAPITRE 2: MATERIALS AND METHODS 2.1. Study type and sites: randomized controlled clinical trial. Sites: Centre Hospitalier du Mont-Amba and Centre de santé Lisungi in Kinshasa, D.R. Congo.

Laboratory testing will be performed in a laboratory based in Antwerp, Belgium. 2.2. Population:

* Women aged 25 and over: There is no upper limit in the study population as for the majority of women this will be the first screening contact for HPV and cervical cancer screening. Testing is not performed in women younger than 25 years old as it can be expected that the prevalence of HPV is very high at a younger age and most women will eliminate the virus after some years.
* Sample size and power calculations:

The investigators would like to have enough power in both the HPV-positive group with and without lesions Assuming a HPV clearance rate of 50% in the non-interventional group and 70% in the virucide group at 2 months post-treatment, a minimum sample size of 163 patients (i.e., 124/site) is needed to show with 95% power and 95% certainty a difference between both groups. To allow for up to 10% drop-outs or unevaluable patients, the investigators will recruit at least 190 patients in each arm.

It is supposed that 50 % of those HPV-positive will demonstrate some lesion on VIA, signifying that our secondary randomization on positive lesion will have approximately the same sample size.

The investigators expect 20% of the women to be HPV positive, of whom 10% with and 10% without lesions, indicating that over 1900 ((190\*2)/20%) women will have to be enrolled to obtain the required sample size.

As the investigators can screen approximately 50 women per week of whom 70% will be willing and eligible to participate, we expect the study recruitment to last 30 weeks and the time between first recruitment and last patient visit to be 56 weeks.

2.3 Study Design

1. Basic training of doctors working in peripheral health centers where no formal laboratory facilities are available.

   Training will involve VIA and taking cervical swabs for HPV testing and for LBC, not needing any special technical skills; health workers can be trained for these within 1 hour.
2. A local screening program based on VIA will then be offered by these trained doctors to all women aged 25 and over; Samples for qPCR HPV DNA detection, viral load and genotyping and for LBC will also be collected at the same time just before the application of acetic acid. The results of these lab tests will not be available at the moment of randomization and will serve for later analysis.

   The results of the cervical cytology will be reported according to the 2001 Bethesda system terminology.
3. Women showing lesions on VIA will be randomized to one of two groups to receive either AV2 virucide treatment or placebo.

   Women without lesion on VIA will not receive any treatment.
4. All women with lesions will be followed-up and rechecked after two months with VIA, qPCR and LBC.
5. In those testing positive with VIA at the control after 2 months, cryotherapy will be offered as per WHO criteria (Annex 4). It will be performed according to 2011 and 2012 WHO Guidelines and Technical Specifications.
6. In case cervical cancer is detected the patient will be treated according to the local protocol and resources.
7. Six months after the first test, an evaluation including VIA, qPCR and LBC will be performed on all subjects who tested positive at the beginning.
8. Those women with persistent precancerous lesions will be offered appropriate treatment.

Those women without lesion at the beginning but whose HPV test or cytology results will be pathologic will be recalled for appropriate management.

Further treatment will be as per local protocol as at this stage the study ends.

2.4. Statistical analyses Data will be double-entered and cleaned in EpiInfo (version 6.04b, Centers for Diseases Control and Prevention).

Proportions will be compared using the x2 or Fisher's exact tests (when required); Student's t test will be used for continuous variables. A paired t test will be used for within-patient comparisons.

Non-normally distributed variables will be transformed, or nonparametric tests (Wilcoxon or Kruskal-Wallis) will be used.

The log-rank test and the proportional hazard will be estimated (after the Schoenfeld test).

In the case of a proportional hazard regression, all patients will be censored at the time of the last recorded visit.

Stepwise multivariate analyses will be performed, and all possible interactions up to order 2 will be tested.

All reported P values will be 2-sided. For all statistical analyses a P value of ≤ 0.05 will be considered as statistically significant.

All analyses will be performed using the STATA statistical analysis software package (at present version 12; Stata Corp.).

2.5. Ethical issues Regulatory Authorities and Ethical Review Committee This protocol will be submitted for approval by the Institutional ethical committee or Institutional review board (IEC/IRB) of the University of Antwerp and of The Kinshasa School of Public Health and will be registered in an international randomized trial registry before starting.

Patients can be enrolled only after formal approval from the EC

Impact of AV2 Antiviral Drug on the Treatment of HPV-associated Lesions of the Uterine Cervix

Efficiency of AV2 Antiviral Drug in the Treatment of Human Papillomavirus-associated Precancerous Lesions of the Uterine Cervix: a Randomized Clinical Trial in Kinshasa, Democratic Republic of the Congo

lesion size" on a scale of 0 - 1 - 2: 0 : for a lesion \< 5 mm

1. : for a lesion 5-15 mm or involving 2 quadrants of the cervix
2. : for a lesion \> 15 mm or involving 3-4 quadrants or endocervically undefined.

0 : for a lesion \< 5 mm

1. : for a lesion 5-15 mm or involving 2 quadrants of the cervix
2. : for a lesion \> 15 mm or involving 3-4 quadrants or endocervically undefined. Copies/cell for HPV DNA

University of Kinshasa

University Hospital, Antwerp

Jean-Pierre Van geertruyden

Prof

Carcinoma

Uterine Cervical Neoplasms

Uterine Neoplasms

Genital Neoplasms, Female

Urogenital Neoplasms

Antineoplastic Agents

Cisplatin

Nelfinavir

HIV Protease Inhibitors

Protease Inhibitors

Enzyme Inhibitors

Anti-HIV Agents

Anti-Retroviral Agents

Fiona Simpkins, MD

Lilie Lin, MD

Patients 18 years of age and older with clinical stages IIA, IIB, IIIA, IIIB, IVA cervical carcinoma limited to the pelvis will receive twice daily oral nelfinavir (NFV) and weekly IV cisplatin in combination as radiosensitizers with daily whole pelvic external beam and intracavitary radiation brachytherapy.

A Study of Nelfinavir Added to Cisplatin Chemotherapy Concurrent With Pelvic Radiation for Locally Advanced Cervical Cancer (II-IVA)

A Phase I Study of Nelfinavir Added to Cisplatin Chemotherapy Concurrent With Pelvic Radiation for Locally Advanced Cervical Cancer (II-IVA)

Abramson Cancer Center at Penn Medicine

Behaviors and Mental Disorders

Constriction, Pathologic

Pathological Conditions, Anatomical

Quality of Life

The number of patients to be recruited in this arm will be 145. Note: The first twenty-five patients who will be included in the study will be allocated in the intervention arm to safety analysis (phase 1); after that all eligible candidates will be randomized 1:1 (phase 2).

Procedure: Loop Electrosurgical Excision Procedure (LEEP) followed by implantation of the device called DUDA (plastic device developed in barretos cancer hospital that will be placed after conization. It has 2.5 cm in length and 5mm in diameter and remains within the endocervical canal for 30 days and is set at 4 points with nonabsorbable sutures in the ectocervix.)

The number of patients to be recruited in this arm will be 120.

Procedure: Loop Electrosurgical Excision Procedure (LEEP) without DUDA device

DUDA device

LEEP

Ricardo Reis, PHD

Cervical stenosis may occur in up to 19% after conization. It is a cause of infertility and amenorrhea. This study will test a new device named DUDA Device ("Dispositivo Uterino para dilatar canal endocervical") placed just after the conization, in order to evaluate the safety, efficacy and quality of life.

This device has the potential to improve outcomes by means of a significant stenosis reduction and maintain patency of the endocervical canal to view the squamo-columnar junction (SCJ) of the cervix during follow-up of this patient.

How to Avoid Cervical Stenosis After LEEP in High Grade Cervical Dysplasia?

A Randomized Study to Evaluate the Safety, Efficacy and Quality of Life of a New Device to Prevent Cervical Stenosis After LEEP in High Grade Cervical Dysplasia

The main safety events to be considered in this analysis are vaginal bleeding and uterine infection. The device is considered unsafe and consequently disrupted the study if a two adverse events Grade 3 or 4 (CTCAE v. 4.0) or a single adverse event Grade 5 related to the procedure/device happens during the phase 1.

Stenosis of the endocervical canal (early and late) will be assessed by clinical information and physical examination at each visit to the hospital after surgery. The participant will be asked about the menstrual flow and dysmenorrhea during history taking. On physical examination, after the visualization of the cervix through the speculum examination, the doctor will check the channel permeability introducing a hysterometer through it. The difficulty of introducing the hysterometer 2.5mm the channel will be scored according to the following scale:

Possible passage of hysterometer? () No difficulty () Little difficult, however possible passage of hysterometer () Unable to pass

The quality of life will be evaluated through questionnaires by the Functional Assessment of Cancer Therapy - Cervix Cancer (FACT-Cx) and the universal pain assessment tools that include international scale and pain visual analogue (EVA), numerical visual pain scale (EVN) and faces pain scales (EF).

It will be evaluated during the following returns and described as any event related directly to the use of DUDA device as metrorrhagia and uterine infection.

It will be assessed during the examination of colposcopy

Barretos Cancer Hospital

Adenocarcinoma

Total Laparoscopic or Robotic Radical Hysterectomy

In a radical hysterectomy the uterus, the upper one to two centimetres of the vagina and the soft tissues around the cervix are excised.

Total Abdominal Radical Hysterectomy

Pedro Ramirez, M.D.

Andreas Obermair, MD

Michael Frumovitz, M.D.

The goal of this clinical research study is to compare the long-term outcomes of different surgical methods for the treatment of cervical cancer. The long-term outcome of a total abdominal radical hysterectomy (TARH) will be compared against laparoscopy. In this study, the laparoscopy will be done with or without robotic technology.

Primary Objective:

To compare disease-free survival amongst patients who undergo a total laparoscopic (TLRH) or robotic radical hysterectomy (TRRH) verses those who undergo a total abdominal radical hysterectomy (TARH) for early stage cervical cancer.

Secondary Objectives:

* Compare patterns of recurrence between arms.
* Compare treatment-associated morbidity within 6 months from surgery.
* Compare the cost effectiveness of TLRH/TRRH versus TARH
* Compare the impact on Quality of Life (QOL) between arms.
* Assess pelvic floor function
* Compare overall survival between arms
* Determine the feasibility of sentinel lymph node biopsy in this group of patients

RATIONALE FOR STUDY DESIGN Total abdominal radical hysterectomy (TARH) and pelvic lymph node dissection (± aortic lymph node dissection ± postoperative \[chemo-\] radiotherapy) is the current standard treatment for early cervical cancer. While this is an accepted effective treatment, a laparotomy is highly invasive, visibly scarring and is associated with tissue trauma, blood loss and a significant risk of wound and infectious adverse events . Additionally, radical hysterectomy by laparotomy is associated with an average hospital stay of approximately 5 to 7 days and an average recovery period (from surgery) of 5 to 6 weeks.

Laparoscopic techniques have been demonstrated to be feasible and safe with previous retrospective studies on TLH showing encouraging results . In a number of retrospective and prospective, non-controlled series the incidence of treatment-related morbidity was less in patients who had a laparoscopic hysterectomy compared to patients who underwent a TAH . Retrospective data suggest that the recurrence rate and patterns of recurrence are similar in patients who had a laparoscopic or an open approach .

Treatment recommendations ideally are based on prospective, randomized trials comparing the current standard technique (TARH) with the proposed better technique (TLRH). However, there are currently no prospective studies available which directly compare TLRH against the standard treatment of TARH in regards to disease-free or overall survival.

The proposed clinical trial will be biphasic. The primary outcome variable in stage 1 will be feasibility of recruitment as determined by overall trial recruitment. Following completion of Stage 1, the data of this study will become the basis for assessing recurrence and disease-free survival in the Stage 2 design.

RATIONALE FOR THE QUALITY OF LIFE Retrospective studies suggest equivalency between the laparoscopic and open approaches to radical hysterectomy in regards to surgical specimens obtained and likely disease-free and overall survivals . Thus, quality of life could be seen as one of the most significant factors in recommending one approach over the other and therefore an extremely important endpoint for this protocol. In the GOG LAP-2 protocol , a trial evaluating a comparison between hysterectomy by laparotomy or laparoscopy, the investigators found equivalency adequacy of the two surgical approaches however a significant difference in short term quality of life favoring laparoscopy. As expected, patients who underwent laparoscopy had a faster return to baseline functioning compared with those patients who had undergone laparotomy which translated into improved short-term quality of life. By 6 months, however, patients in both cohorts were reporting equivalent quality of life parameters. Quality of life surveys employed with this Phase III clinical trial will encompass important endpoints such as postoperative pain and related symptoms using the MD Anderson Symptom Assessment Index (MDSAI), as well as cancer specific Functional Assessment of Cancer Therapy (FACT-Cx) and the general 12-Item Short-Form Health Survey (SF-12).

RATIONALE FOR LYMPHATIC MAPPING Published experience with the techniques for lymphatic mapping and sentinel lymph node detection in women with cervical cancer has been very limited. To date, no single study has enrolled more than 100 patients undergoing lymphatic mapping as part of their surgical treatment for cervical cancer. In fact, the majority of studies report on less than 50 patients. In addition, this procedure has not yet been shown to be viable in a multi-institutional setting. The limitations of previously published reports are important as these techniques are associated with a significantly high learning curve with early procedures less successful than later ones. This study will provide us the opportunity to enroll large numbers of patients for validation of intraoperative lymphatic mapping in women with cervical cancer in an international, multi-institutional setting.

Laparoscopic Approach to Cervical Cancer

A Phase III Randomized Clinical Trial of Laparoscopic or Robotic Radical Hysterectomy Versus Abdominal Radical Hysterectomy in Patients With Early Stage Cervical Cancer

date and localization of 1st recurrence as confirmed histologically - Compare patterns between groups

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Expectancy as Alternative to Treatment for Cervical Intraepithelial Neoplasia Grade 2 Among Women 25 - 30 Years of Age	NCT03177863	CIN2 Therapy	Expectancy	25 Years - 30 Years	Sahlgrenska University Hospital, Sweden
Impact of AV2 Antiviral Drug on the Treatment of HPV-associated Lesions of the Uterine Cervix	NCT02346227	Uterine Cervica... Papillomavirus ...	AV2 Placebo	25 Years -	Universiteit Antwerpen
A Study of Nelfinavir Added to Cisplatin Chemotherapy Concurrent With Pelvic Radiation for Locally Advanced Cervical Cancer (II-IVA)	NCT02363829	Uterine Cervix ...	Nelfinavir Cisplatin	18 Years -	Abramson Cancer Center at Penn Medicine
How to Avoid Cervical Stenosis After LEEP in High Grade Cervical Dysplasia?	NCT02500966	Stenosis Cervix	DUDA device LEEP	18 Years - 65 Years	Barretos Cancer Hospital
Laparoscopic Approach to Cervical Cancer	NCT00614211	Cervical Cancer	Total Abdominal... Total Laparosco...	18 Years -	Queensland Centre for Gynaecological Cancer
Expectancy as Alternative to Treatment for Cervical Intraepithelial Neoplasia Grade 2 Among Women 25 - 30 Years of Age	NCT03177863	CIN2 Therapy	Expectancy	25 Years - 30 Years	Sahlgrenska University Hospital, Sweden
A Study of Nelfinavir Added to Cisplatin Chemotherapy Concurrent With Pelvic Radiation for Locally Advanced Cervical Cancer (II-IVA)	NCT02363829	Uterine Cervix ...	Nelfinavir Cisplatin	18 Years -	Abramson Cancer Center at Penn Medicine

Spots Global Cancer Trial Database for uterine cervix