Changes of T Lymphocyte Subsets in Peripheral Blood of Patients with Intermediate and Advanced Cervical Cancer before and after Nimotuzumab Combined with Chemoradiotherapy

Abstract

<b><i>Introduction:</i></b> Cervical cancer (CC) is the main malignant tumor of gynecology with high mortality. This study aimed to explore the changes of T lymphocyte subsets in the peripheral blood of patients with intermediate and advanced CC (IACC) treated with nimotuzumab (Nimo) combined with chemoradiotherapy (CRT). <b><i>Methods:</i></b> Peripheral blood was extracted before and after treatment, and patients were randomly divided into the CRT group (<i>N</i> = 68) or the Nimo + CRT group (<i>N</i> = 68). The levels of tumor markers squamous cell carcinoma antigen (SCCA), carbohydrate antigen 125 (CA125), and carcinoembryonic antigen (CEA), tumor indexes leptin and insulin-like growth factor-2 (IGF2), and key secretory factors (interferon γ/tumor necrosis factor α/interleukin (IL)-4/IL-13) of Th1 and Th2 cells in the serum were detected. The levels of T lymphocyte subsets CD3+, CD4+, CD8+, and CD4+/CD8+ and the levels of Th1/Th2 and Th17/Treg in CD4+ cell subsets were determined by flow cytometry. The objective remission rate, progression-free survival (PFS), and overall survival (OS) of patients were analyzed, and Kaplan-Meier curves were drawn to show the prognosis of patients. <b><i>Results:</i></b> After treatment, the levels of SCCA, CA125, CEA, leptin, and IGF2 in the serum of patients with IACC were decreased, the level of Th1/Th2 was increased, and the Th17/Treg level was decreased. The treatment effect of Nimo + CRT was more significant than that of CRT alone. Survival curve analysis showed that Nimo + CRT could prolong PFS and OS in patients with IACC. In addition, the follow-up results of patients showed that Nimo did not increase the incidence and severity of adverse reactions caused by CRT. <b><i>Conclusion:</i></b> Nimo combined with CRT can protect the immune function of patients, improve the effective rate, and prolong the survival rate of patients with IACC.

Correlation of INHBA Overexpression with Pathological Features, Antitumor Immune Response and Clinical Prognosis in Cervical Cancer

“…IFN-γ not only exerts a key role in coordinating innate and adaptive immune responses against viruses, bacteria and tumors, but has an important role in promoting pathological inflammation [ 15 ]. A previous study has revealed that the levels of IFN-γ, IL-4 and IL-6 in the serum of patients with CC are significantly higher than that in the normal population, which may play an important role in the occurrence of CC [ 16 ]. In addition, IFN-γ may promote the secretion of cytokines such as IL-1β, TNF-α, and IL-12, and trigger Th1 antigen-specific reaction and immune response, thus enhancing immune function.…”

New clinical trial design in precision medicine: discovery, development and direction

“…Furthermore, in tumors with squamous characteristics, such as head and neck carcinoma, cervical, and Chinese esophageal cancers, the ORR of EGFR inhibition therapy combined with radiotherapy and chemotherapy is up to ~90%, showing improved survival compared to radiotherapy and chemotherapy alone. 118 – 121 Similarly, the ORR of EGFR inhibition combined with chemotherapy for female reproductive system tumors, such as ovarian and breast cancers, also exceeds 50%. 122 , 123 …”