Yong Lit Chen Chen

Cervical cancer is a leading global health burden, especially in the context of low- and middle-income countries where screening and vaccination coverage are still low. Although prevention strategies have improved; however, the case for effective treatment modalities remain. Cervical cancer has undergone significant changes in its management since the introduction of multiple therapeutic options over the years. Management of early-stage disease can entail surgical options including conization, hysterectomy, trachelectomy, and pelvic exenteration. Radiotherapy with external beam radiation or brachytherapy remains fundamental to treatment and is frequently administered alongside chemotherapy aimed at improving sensitivity. For locally advanced and metastatic disease, chemotherapy (especially platinum-based regimens) is still the mainstay of treatment, and newer targeted therapies appear effective. In the last few years, immunotherapy has appeared as a revolutionary strategy, among the immune checkpoint inhibitors, therapeutic vaccines, and adoptive cell therapies showed promising results. Moreover, novel targeted therapeutics and combination approaches are being investigated in clinical trials, ushering in an era of personalized medicine for the cervical cancer patient population. Although these advancements lead to improved outcomes for patients, issues related to treatment selection, quality of life, fertility preservation, and access to care continue to be of utmost importance. This review summarizes the status of lock-in treatments in cervical cancer, illustrating both current use and future directions for established and emerging lock-in therapies, with an eye on their real-world clinical implementation and future directions.

A 2-year-old boy presented to the paediatric emergency department with a 5-day history of persistent high fever reaching 40°C, marked irritability, reduced oral intake, and non-productive cough. The child's mother reported onset of symptoms following a minor upper respiratory infection two weeks earlier, initially managed at home with oral paracetamol and later with oral antibiotics (amoxicillin) prescribed by a primary care physician, which failed to resolve the fever or other emerging symptoms. On examination, the child exhibited bilateral non-exudative conjunctival injection, strawberry tongue with red cracked lips, anterior cervical lymphadenopathy (right sided, 2 cm node), polymorphous erythematous rash across the trunk and extremities sparing the diaper area, and indurative oedema of the hands and feet. These findings fulfilled the diagnostic criteria for complete Kawasaki disease (KD), prompting immediate hospital admission for further evaluation and treatment.