Danya Garza

Background: Human Papillomavirus (HPV) is a DNA virus that infects both men and women and can cause issues ranging from genital warts to cervical, oral, and penile cancers.¹ HPV is transmitted via sexual contact and is considered the most transmitted sexually transmitted disease in the world.¹ This virus causes almost all cases of cervical cancer in women. Significant efforts are put into raising awareness of the HPV vaccination, which helps prevent eventual cervical cancer. It is a vaccine that can be administered to men and women as young as 9 years old. While this has been helping cervical cancer rates decline, it has left a gap in treatments for those who already have cervical cancer.² Currently, treatment for cervical cancers includes a loop electrosurgical excision procedure (LEEP) or cold knife conization (CKC).³ While these therapies are efficacious, they are invasive and can lead to infertility. This led to the question of whether there was a better option for treatment.

Objective:  In this review, I aimed to determine the feasibility and mechanisms of photodynamic therapy for cervical cancer treatments.

Search Methods:  An online search in the PubMed database was conducted from 2017 to 2025 using the following keywords: “HPV”, ” Therapy”, “PDT”, ” photodynamic therapy”.

Results:  After taking some time to look at less invasive treatment options, I found out about PDT. It has been used in different cancers, but it is being studied for use in cervical cancer. It works by using photosensitizing agents and red light to selectively kill cancerous cells via mitochondrial stress.³ When further studied, one paper found that it also kills cancerous cells via endoplasmic reticulum stress.⁴  Another study found that PDT inhibits the viability, proliferation, and migration of cervical cancer cells via the miR–152–3p/JAK1/STAT1 pathway. miR-152-3p is a microRNA that acts as a tumor suppressor. It inhibits cell proliferation and the migration of cancerous cells, as well as promotes apoptosis of these cells.⁵  A different study found Seryl‐tRNA synthetase (SerRS) to be a potent anti‐angiogenic factor, directly binding the Vascular Endothelial Growth Factor promoter to reduce transcription.⁶ Overall, this decreases the formation and development of new vessels.  Lastly, one study focused on the efficacy of different light waves for treatments. The most common light used for PDT is red light in the 600-800 nm range. In one study, a 450 nm blue laser was used to help treat HR-HPV-infected cells.⁷ When compared to the more commonly used 635 nm laser, the 450 nm laser (blue light) had decreased tumor volume. Along with decreased tumor volume, the blue light showed an increase in cells that died via apoptosis.⁷

Conclusion:  In summary, PDT is an efficacious and minimally invasive option for women suffering from cervical cancer induced by HPV infections.⁸ PDT works by many different mechanisms, and more mechanisms and changes in traditional treatment are being studied. This means that while PDT works well currently, more research could provide even more improvements. This greatly impacts the work of oncologists and OB/GYNs in managing their patients.

Work Cited:

1.  Mlynarczyk-Bonikowska B, Rudnicka L. HPV Infections-Classification, Pathogenesis, and Potential New Therapies. Int J Mol Sci. 2024;25(14):7616. Published 2024 Jul 11. doi:10.3390/ijms25147616
2. Bhatla N, Singhal S. Primary HPV screening for cervical cancer. Best Pract Res Clin Obstet Gynaecol. 2020;65:98-108. doi:10.1016/j.bpobgyn.2020.02.008
3. N, Bariyeva G, Avdeyev A, et al. Evaluation of the effectiveness and safety of photodynamic therapy in the treatment of precancerous diseases of the cervix (neoplasia) associated with the human papillomavirus: A systematic review. Photodiagnosis and Photodynamic Therapy. 2024;45:103925. doi:10.1016/j.pdpdt.2023.103925
4. Li Z, Teng M, Wang Y, et al. The mechanism of 5‐aminolevulinic acid photodynamic therapy in promoting endoplasmic reticulum stress in the treatment of HR‐HPV‐infected Hela cells. Photodermatology, Photoimmunology & Photomedicine. 2021;37(4):348-359. doi:10.1111/phpp.12663
5. Wang X, Xu L, Chen J, et al. 5-aminolevulinic acid photodynamic therapy inhibits the viability, invasion, and migration of cervical cancer SiHa cells by regulating the miR-152-3p/JAK1/STAT1 axis. Photodiagnosis Photodyn Ther. 2024;49:104283. doi:10.1016/j.pdpdt.2024.104283
6. Lu H, Peng Z, Luo Y, et al. Emodin combined with 5-aminolevulinic acid photodynamic therapy inhibits condyloma acuminate angiogenesis by targeting SerRS. J Cell Mol Med. 2024;28(19):e70122. doi:10.1111/jcmm.70122
7. Chen Y, Mei Y, Gu L, Li X, Guo P, Chen L, He D. A novel PDT: 5-aminolevulinic acid combined 450 nm blue laser photodynamic therapy significantly promotes cell death of HR-HPV infected cells. Artif Cells Nanomed Biotechnol. 2023;51(1):22-32. doi:10.1080/21691401.2022.2164585.
8. Chen Y, Xu Y, Zhang Z, Xiong Z, Wu D. 5-aminolevulinic acid-mediated photodynamic therapy effectively ameliorates HPV-infected cervical intraepithelial neoplasia. Am J Transl Res. 2022;14(4):2443-2451. Published 2022 Apr 15.