“The International Papillomavirus Society conference brings together the world’s leading researchers working to eliminate cervical cancer,” said Dr. Mungo. “It was an honor to represent UNC and share insights on how we can improve screening and treatment access in communities that need it most.”
The conference also highlighted promising results from a National Cancer Institute-funded clinical trial led by UNC researchers. Lisa Rahangdale, MD, MPH, Professor of Obstetrics and Gynecology, and Carla Chibwesha, MD, MSc, Associate Professor of Obstetrics and Gynecology, presented findings from their ACT 2 trial examining intravaginal 5-fluorouracil (5FU) cream following surgical treatment in South African women living with HIV who have cervical precancer.
Conducted by Dr. Chibwesha’s team at the University of the Witwatersrand in South Africa, the ACT 2 trial enrolled 180 women with high-grade cervical precancer who underwent loop electrosurgical excision procedure (LEEP) and were randomized to receive either 5FU or placebo cream over 16 weeks. Intravaginal 5FU was found to be safe and acceptable to women. By Week 24, 96% of women in the 5FU group achieved regression low-grade disease or had no evidence of disease , compared to 82% in the placebo group. The benefit of 5FU for women with positive surgical margin was even more pronounced: 88% of women in the 5FU group achieved regression compared to 60% in the placebo group. Additionally, among women with HPV16—a high-risk strain that causes most cervical cancers—74% receiving 5FU cleared the virus, compared to 40% in the placebo group.
Dr. Chibwesha noted that the results were particularly meaningful in settings with a high burden of both cervical cancer and HIV, saying, “we designed this study to address the critical gap in treatment options for women living with HIV. The success of our trial—the first trial of its kind in Africa—represents a major advance for the field and we look forward to conducting follow-on studies that could benefit thousands of women in sub-Saharan Africa and beyond.”
“Women living with HIV face significantly higher risks of persistnt HPV infection and progression to cervical cancer, even after treatment,” said Dr. Rahangdale. “Our findings suggest that intravaginal 5FU may offer a valuable adjuvant therapy to improve outcomes for this vulnerable population.”
Two students mentored by Dr. Mungo also presented posters: Jessica Gingles from UNC School of Medicine and Annum Sadan from NYU School of Medicine.
Cervical cancer causes more than 340,000 deaths annually worldwide, disproportionately affecting women in low- and middle-income countries where access to screening and treatment is limited. The IPVS conference is the premier international gathering for advancing HPV and cervical cancer prevention research globally.
