Source: Sabahi
Nairobi — Doctors at Kenyatta National Hospital in Nairobi have successfully used Lopinavir, a drug used to treat human immunodeficiency virus (HIV), to treat 40 women with cervical cancer, a clinical trial released March 6th showed.

Doctor Innocent Orora Maranga, a gynaecologist and the lead researcher of the trial, told Sabahi that the drug trial came as result of laboratory research he carried out with a team of other doctors at the University of Manchester in the United Kingdom in 2006 on the use of anti-viral drugs to treat cancer.

"In Manchester we did several laboratory tests, and out of the six HIV drugs that were tested on the human papilloma virus (HPV), the cancer-causing virus, only Lopinavir proved to have 100% efficacy levels due to its high concentration, which makes it easier to kill the cancerous cells," he said.

Based on those findings, Maranga received approval to carry out a clinical trial in Kenya that began at Kenyatta National Hospital in February 2013, he said.

The 40 patients selected for the trial were treated for 14 days with a special gel-based formula of Lopinavir developed and used for application directly on the cervix.

"The gel melts easily and faster smearing itself on the women's birth canals where the cancerous cells are found," Maranga said. "The 40 women, who were all HPV-positive with either high-grade, borderline or low-grade disease, were treated with one [gel] capsule of the anti-viral drug twice a day for two weeks."

"If we had given the patients the capsules or solutions orally it could have led to overdose, which could have had very costly side effects," Maranga said. "The gel was the best option because it has no side effect to the patients even in its high concentration state."

After 90 days, cervical cells in 21 of the 23 women who had initially been diagnosed with "high-grade" disease returned to normal, and in two of the women, the cancerous cells were downgraded to "low-grade" disease, he said. "The 17 women initially diagnosed with borderline or low grade disease also showed similar improvement," he added.

The patients were re-tested after ten months and showed the same results.

In addition to having normal Papanicolaou test (Pap smear) results, images of the cervix before and after treatment showed clear regression of the cervical lesions with no adverse reactions or side effects to patients who took part in the trial, Maranga said, meaning the patients had been healed completely.

All the patients who participated in the first round of the trial will continue to be monitored for the next 12 months, he said.

Potential to revolutionise treatment of cervical cancer

"We have seen women with high-grade disease revert to a normal healthy cervix within a comparatively short period of time," doctor Lynne Hampson, a researcher from the University of Manchester Institute of Cancer Sciences who is working on the trial, said in a press briefing at Kenyatta National Hospital during the announcement of the study results on March 6th.

"For an early stage clinical trial the results have exceeded our expectations," she said. "We are convinced that further optimisation of the dose and treatment period will improve the efficacy. It is our hope that this treatment has the potential to revolutionise the management of this disease, most particularly in developing nations such as Kenya."

Joselyn Akinyi, a 30-year-old Kibera resident who was diagnosed with high-grade cervical cancer in January 2012, said she was one of the first women to agree to undergo the clinical trial.

"I do not regret taking part in it because I have healed completely," she told Sabahi, adding that if it had not been for the treatment she would have had to undergo a hysterectomy, a medical operation to remove a woman's uterus.

"I know there are many women in the same condition that I was in who need help that can only come if these trial results can be enhanced," she said. "We pray that the doctors will work around the clock to make sure that this [drug is] rolled out countrywide to target all the poor women in Kenya who are staring at unnecessary deaths due to cancer."

Mary Kamau, 27, a housewife who lives in Nairobi's Kayole area, said she was diagnosed with high-grade cervical cancer in February 2014.

Although waiting for next round of trials would jeopardise Kamau's chances of survival, she said, "The breakthrough will give hope to many other women."

"The only option I have is to undergo surgery," she said, adding that she is scheduled for a hysterectomy in April.

Next trial expected to treat 3,000 women

Kenyatta National Hospital chief executive officer Lily Koros Tare said the hospital would support future studies.

"The findings provide a cheap and easy way of dealing with cancer," she told Sabahi. "Initially patients had to rely on surgery or get prophylactic vaccines to prevent [HPV], which has been expensive and has not been effective in curing the disease."

According to Tare, more than 2,454 cases of cervical cancer are diagnosed in Kenya. Of those, 1,676 die annually. Kenyatta National Hospital is one of only two referral hospitals in the country.

Doctor Peter Gichangi, who supervised the first clinical trial, told Sabahi the next trial would include 3,000 women and is scheduled to start in August pending approval from medical ethical review boards and the availability of funds. "

"If the results are this positive, then this treatment will be available for roll out to the entire public in need," he told Sabahi, urging all women to be pro-active and get regular screenings to ensure early detection.

• Kenya