PD-1 inhibitor plus concurrent chemoradiotherapy for high-risk locally advanced cervical cancer

Abstract

Aim: The prognosis of high-risk, locally advanced cervical cancer (LACC) remains poor following concurrent chemoradiotherapy (CCRT). We investigated whether the effect of CCRT can be enhanced by programmed cell death protein 1 (PD-1) inhibitor.Methods: A retrospective cohort study was conducted to compare the efficacy and safety of CCRT group (n = 82) and PD-1 inhibitor plus CCRT group (n = 70).Results: Compared with the CCRT group, the PD-1 inhibitor plus CCRT group had significantly higher objective response rate, median progression-free survival, leukopenia and fatigue. The addition of PD-1 inhibitor to CCRT showed a favorable trend in overall survival without statistical significance.Conclusion: PD-1 inhibitor plus CCRT presented a significant survival benefit and a manageable safety profile in high-risk LACC.

Keywords: PD-1 inhibitor; concurrent chemoradiotherapy; efficacy; local advanced cervical cancer; safety.

Figure 1.

Flow chart of the selection process. CCRT: Concurrent chemoradiotherapy; ECOG: Eastern Cooperative Oncology Group; FIGO: Federation Internationale of Gynecologie and Obstetrigue.

Figure 2.

Survival outcomes of high-risk locally advanced cervical cancer patients. (A) Progression-free survival (PD-1 inhibitor plus CCRT group vs CCRT group). (B) Overall survival (PD-1 inhibitor plus CCRT group vs CCRT group). (C) Progression-free survival (PD-L1-positive vs PD-L1-negative groups). (D) Overall survival (PD-L1-positive vs PD-L1-negative groups). CCRT: Concurrent chemoradiotherapy; LACC: Locally advanced cervical cancer; PD-1+CCRT: PD-1 inhibitor plus CCRT group; PDL-1: Programmed death ligand-1.