New cervical cancer pill shows promise by stopping HPV from turning cancerous

How does SHetA2 work?

SHetA2 is a small molecule therapy that is designed to stop an HPV infection from causing cancer. (Small molecule therapies are chemically manufactured, low-weight compounds that can easily be absorbed by the body. Manufacturing them is also easy and cost-effective.)

This therapy targets three proteins in the human body called mortalin, heat shock cognate (hsc70), and glucose regulated protein 78 (Grp78). These are essential for the proliferation of the cancer-causing oncoprotein of the virus. “It works by breaking the connection between the HPV-E7 protein and a host protein inside human cells. Normally, this host protein protects E7 and allows it to keep damaging healthy cells. When SHetA2 breaks this connection, the harmful E7 protein is destroyed by the body’s normal immune defences,” explains Dr. Showket Hussain, senior scientist from ICMR National Institute of Cancer Prevention and Research (ICMR-NICPR).

This mechanism also ensures that the therapy selectively affects the cancer cells while sparing the normal ones.

Who needs to take it?

The therapy is meant for those who have developed precancerous lesions of cervical cancer. “Based on current preclinical evidence, it has potential applications in treating high-grade cervical intraepithelial neoplasia (cancerous lesions that are highly likely to turn into cancer if left untreated) and invasive cervical cancer. But, phase II clinical studies will determine the exact patient population and stage at which it is most effective,” says Dr Hussain.

In what form?

The therapy has, at present, been evaluated in an oral, capsule form. However, researchers are now exploring localised delivery mechanisms such as vaginal suppository. “This will maximise the concentration of the drug in the cervix while reducing exposure across the body,” says Dr Hussain.

What stage of development is it at?

While the Stephenson Cancer Center, University of Oklahoma, discovered and developed the treatment, ICMR-NICPR evaluated its efficacy in pre-clinical studies and validated its mechanism of action. Both institutions collaboratively hold the intellectual property rights for therapy.

After the pre-clinical and early clinical trials of the therapy, it has been transferred to Emcure Pharmaceuticals for further development. The company will now be responsible for carrying out larger human trials before making the therapy available in the market. “These trials may take up to five years,” says Dr Hussain.

How much will the pill cost?

The final cost of the therapy is yet to be determined. It will depend on the cost of clinical trials, manufacturing, regulatory approvals and commercialisation strategies for the product.

“However, as an orally administered small-molecule drug, it is expected to be considerably more affordable than many biologic or immunotherapy-based cancer treatments. It may reduce the need for hospitalisation, prolonged hospital visits, or infusion-based care, as the medication may be taken at home by many,” says Dr Hussain.

Do you still need to get your HPV shot and pap smear test?

Yes. Tests such as pap smear, HPV DNA — or even the simple visual inspection with acetic acid — can detect the precancerous or cancerous lesions. Early detection is necessary for early initiation of treatment, which can improve the outcomes. The SHetA2 therapy, when it becomes available, is also likely to be given to patients who have been diagnosed with these lesions or cancer.

A vaccine — which usually contains the four strains that are most likely to cause cancer — can actually prevent the HPV infection that can lead to cervical cancer. The government earlier this year rolled out HPV vaccination for all 14-year-old girls earlier this year.