The promise of PD1/PDL1 targeted immunotherapy in locally advanced cervical cancer: a game-changer for patients outcome?

Abstract

Locally advanced cervical cancer remains a significant therapeutic challenge, with high rates of recurrence and metastasis despite advances in chemoradiation. Immunotherapy, particularly immune checkpoint inhibitors targeting the PD-1/PD-L1 axis, has emerged as a promising strategy to enhance treatment efficacy. This review explores the integration of immunotherapy with standard chemoradiation, highlighting the potential of PD-1 inhibitors, such as pembrolizumab, in improving progression-free survival (PFS) among high-risk patients. Furthermore, the role of predictive biomarkers, including microsatellite instability (MSI) and tumor mutational burden (TMB), is examined to refine patient selection and personalize therapeutic approaches. Emerging strategies, including the use of nivolumab, ipilimumab, and maintenance immunotherapy, are also discussed. While preliminary clinical data are encouraging, further research is required to optimize treatment combinations, establish robust patient selection criteria, and enhance long-term outcomes in cervical cancer management.

Keywords: biomarkers; cervical cancer; chemoradiation; clinical trial; immune checkpoint inhibitors; immunotherapy; personalized treatment.

Figure 1

Schematic overview of immunotherapeutic strategies for locally advanced cervical cancer. (A) Strategies to induce and enhance cervical cancer-specific T Cells. VGX-3100: HPV16/18 vaccine; Z-100: Mycobacterium tuberculosis extract. (B) Strategies to block immune checkpoints and restore T-cell function. PD-1: Programmed cell Death protein 1; CTLA-4: Cytotoxic T Lymphocyte Associated Protein 4. (C) Strategies using adoptive cell therapy to augment TILs. (D) CAR-T cell therapies targeting HPV-associated proteins.