Efficacy and Prognostic Factors for Response to PD-1 Inhibitors in Advanced Cervical Carcinoma: A Retrospective Study

Cheng, Mingxia; Wang, Haihong; Zhao, Yingchao; Li, Guiling

doi:10.2147/dddt.s358302

Cited by 8 publications

(8 citation statements)

References 26 publications

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“…After reviewing titles and abstracts, 46 studies were selected for full-text review. Finally, 19 studies that met the inclusion criteria were included in this meta-analysis ( 4 , 12 – 29 ).…”

Section: Resultsmentioning

confidence: 99%

“…This meta-analysis included 21 trials from 19 studies, involving 2097 patients with ARMCC. Among them, there were 15 observational studies ( 4 , 12 , 13 , 15 – 19 , 21 , 22 , 24 , 25 , 27 – 29 ), one expansion cohort study ( 23 ), and three RCTs ( 14 , 20 , 26 ). All studies included at least one group that received treatment with PD-1 inhibitors.…”

Section: Resultsmentioning

confidence: 99%

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Clinical benefit analysis of PD-1 inhibitors in patients with advanced, recurrent or metastatic cervical cancer: a meta-analysis and systematic review

Wang,

et al. 2024

Front. Immunol.

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PurposeThis study aims to comprehensively evaluate the efficacy and safety of programmed cell death protein-1 (PD-1) in patients with advanced, recurrent, or metastatic cervical cancer (ARMCC) and identify the population that may benefit the most.MethodsWe conducted a search of PubMed, EMBASE, and the Cochrane Collaboration Library from their inception to September 2023. We extracted and analyzed the results related to the efficacy and safety of PD-1 in patients with ARMCC. The primary endpoints included the overall objective response rate (ORR) and adverse events (AEs), while the secondary endpoints encompassed the 1-year overall survival (OS) rate, 1-year progression-free survival (PFS) rate, as well as OS and PFS. We used a random effects model to conduct a meta-analysis on single-group rates, and the Mantel-Haenszel method was utilized to compare the ORR and the incidence of AEs.ResultsOur study included a total of 21 trials involving 2,097 patients. The ORR of the combination of PD-1 inhibitors with chemotherapy was 56.36%, the combination of PD-1 inhibitors with anti-angiogenic agents was 38.72%, the combination of PD-1 inhibitors with Cytotoxic T-lymphocyte antigen 4 inhibitors was 25.60%, and PD-1 inhibitor monotherapy was 15.99%. The subgroup analysis showed that the group of patients with squamous cell carcinoma (SCC) exhibited a significantly higher ORR compared to the non-SCC group in patients who received PD-1 inhibitors combined with other anti-tumor drugs (Odds Ratio =2.43, P=0.002). Additionally, the group of patients with a programmed death-ligand 1 combined positive score (PD-L1 CPS) ≥1 exhibited a significantly higher ORR compared to the PD-L1 CPS <1 group in patients who received PD-1 inhibitor monotherapy (OR=4.14, P=0.02). PD-1 inhibitor monotherapy or PD-1 inhibitors combined with chemotherapy did not significantly increase the incidence of all grades of adverse events (Relative Risk=0.99, p=0.788) or the incidence of serious adverse events (RR=0.99, p=0.788) compared to chemotherapy alone.ConclusionPD-1 inhibitors demonstrate outstanding efficacy in the treatment of patients with ARMCC. Patients with SCC may benefit more from treatments including PD-1 inhibitors in combination with other anti-tumor drugs, and PD-L1 CPS ≥1 can be considered a favorable indicator of immune therapy response. Importantly, the use of PD-1 inhibitor monotherapy or PD-1 inhibitors in combination with chemotherapy did not lead to an increased incidence of AEs compared with chemotherapy alone, indicting safety during treatment.Systematic Review RegistrationPROSPERO (CRD42023457945).

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Clinical benefit analysis of PD-1 inhibitors in patients with advanced, recurrent or metastatic cervical cancer: a meta-analysis and systematic review

Wang,

et al. 2024

Front. Immunol.

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“…Our study showed that the combination therapy group had better survival than the combination therapy of previous studies. A previous study by Cheng et al found that the ORR and PFS of patients with advanced cervical cancer in combination with immune checkpoint inhibitors ranged from 0–65.9% and 2.9–13.8 months, respectively ( 10 ). In our study, the ORR was 44.7% and the median PFS was 10.3 months, which is consistent with the findings of Cheng et al ( 10 ).…”

Section: Discussionmentioning

confidence: 99%

“…A previous study by Cheng et al found that the ORR and PFS of patients with advanced cervical cancer in combination with immune checkpoint inhibitors ranged from 0–65.9% and 2.9–13.8 months, respectively ( 10 ). In our study, the ORR was 44.7% and the median PFS was 10.3 months, which is consistent with the findings of Cheng et al ( 10 ). Thus, the combination of PD-1 inhibitors and chemotherapy can improve the survival of patients compared to PD-1 inhibitors or chemotherapy alone.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and optimal combination timing of chemotherapy combined with PD-1 inhibitor in advanced cervical cancer: a multicenter retrospective cohort study

Cheng¹,

Zhang²,

Zhang³

et al. 2022

Ann Transl Med

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Background: This study aimed to investigate the efficacy and safety of chemotherapy combined with programmed cell death protein 1 (PD-1) inhibitors in the treatment of advanced cervical cancer and the effect of optimal combination timing on prognosis.Methods: From March 2020 to December 2021, the clinical data of 116 patients with advanced cervical cancer who received PD-1 inhibitors combined with chemotherapy were collected. The clinical characteristics and adverse events of the patients were recorded until the cut-off date of follow-up. The primary endpoints were progression-free survival (PFS), the objective response rate (ORR), and safety; the secondary endpoints were the disease-control rate (DCR) and overall survival (OS). Multivariate Cox proportional hazards regression was used to analyze the prognostic factors affecting the PFS of patients and to assess the effect of the timing of combination therapies on PFS.Results: In total, 85 patients from 4 study centers were included in this study. The median PFS was 10.3 months [95% confidence interval (CI): 9.47-11.13 months], the ORR was 44.7%, the DCR was 75.3%, and the median OS was not reached. The multivariate Cox proportional hazards regression analysis showed that the early combination of chemotherapy with a PD-1 inhibitor provided better PFS than the late combination [hazard ratio (HR) 0.40, 95% CI: 0.24-0.67, P=0.001]. Lymph node metastasis (HR 2.04, 95% CI: 1.24-3.38, P=0.005), and previous treatment (HR 1.79, 95% CI: 1.09-3.00, P=0.023) were also independent risk factors for PFS. During the treatment and follow-up periods, the overall incidence of adverse events in this study was 56.5%, and that of grade ≥3 adverse events was 12.9%. Thrombocytopenia, neutropenia, anemia, and hypothyroidism were the main treatment-related adverse events, all of which were tolerated, and no serious adverse events leading to death were observed. There were no treatment-related deaths.Conclusions: PD-1 inhibitors combined with chemotherapy have good efficacy and controllable safety in patients with advanced cervical cancer. The early combination of PD-1 inhibitors and chemotherapy may provide better survival benefits than the late combination for patients.

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“…A retrospective study of 102 patients with R/M CC who received treatment with the PD-1 mAb (Sintilimab/Camrelizumab) in combination with or without anti-angiogenic medicines (Apatinib) in China showed an ORR of 51.0%, a DCR of 66.7%, and a median PFS of 11.0 months. This study found that the combination of PD-1 blockade of chemotherapy and anti-angiogenic medicines successfully extended the ORR and PFS of patients with R/M CC, especially among those with squamous carcinoma, with a recurrence time >6 months ( 61 ).…”

Section: Combination Therapy For R/m CCmentioning

confidence: 92%

Immune checkpoint blockade for locally advanced or recurrent/metastatic cervical cancer: An update on clinical data

Song

Zou

2022

Front. Oncol.

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Immunotherapy has shown great promise in the field of oncology, and recent clinical trials have illustrated that immune checkpoint blockade (ICB) is safe and effective at treating a range of tumor types. Cervical cancer (CC) is the fourth most common malignancy in women. However, first-line treatments for locally advanced cervical cancer (LACC) and recurrent/metastatic (R/M) CC have limited efficacy. Thus, it is necessary to explore new treatment approaches. The National Comprehensive Cancer Network (NCCN) currently recommends pembrolizumab, a programmed cell death protein 1 (PD-1) monoclonal antibody, as a first line therapy for individuals with R/M CC. This study reviews the progress of ICB therapy for LACC and R/M CC and describes the current status of the combination of ICB therapy and other therapeutic modalities, including radiotherapy, chemotherapy, targeted therapy, and other immunotherapies. The focus is placed on studies published since 2018 with the aim of highlighting novel CC-specific immunotherapeutic approaches and treatment targets.

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Efficacy and Prognostic Factors for Response to PD-1 Inhibitors in Advanced Cervical Carcinoma: A Retrospective Study

Cited by 8 publications

References 26 publications

Clinical benefit analysis of PD-1 inhibitors in patients with advanced, recurrent or metastatic cervical cancer: a meta-analysis and systematic review

Clinical benefit analysis of PD-1 inhibitors in patients with advanced, recurrent or metastatic cervical cancer: a meta-analysis and systematic review

Efficacy and optimal combination timing of chemotherapy combined with PD-1 inhibitor in advanced cervical cancer: a multicenter retrospective cohort study

Immune checkpoint blockade for locally advanced or recurrent/metastatic cervical cancer: An update on clinical data

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