Current Status of Clinical Trials for Cervical and Uterine Cancer Using Immunotherapy Combined With Radiation

Dyer, Brandon A.; Feng, Christine H.; Eskander, Ramez N.; Sharabi, Andrew B.; Mell, Loren K.; McHale, Michael; Mayadev, Jyoti

doi:10.1016/j.ijrobp.2020.09.016

Cited by 38 publications

(34 citation statements)

References 86 publications

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“…Meanwhile, existing studies have preliminarily confirmed the efficacy and safety of RISI in the treatment of cervical cancer [16,20,21]. Meanwhile, recent studies indicated that radiotherapy induces immunomodulatory effects [22][23][24][25]; therefore, we expect the combination of PD-1 immune checkpoint inhibitor and RISI radiotherapy would improve prognosis compared with monotherapy and presented this case.…”

Section: Introductionmentioning

confidence: 74%

“…In the past, it was viewed as an immunosuppressant [ 58 , 59 ]. Recent studies have demonstrated that radiotherapy will induce immunomodulatory effects through the tumor microenvironment and upregulation of the inflammatory cascade [ 22 , 23 , 24 , 25 ]. The ideal combination of immunotherapy and radiotherapy should overcome the resistance mechanisms.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

PD-1 Inhibitor Maintenance Therapy Combined Iodine-125 Seed Implantation Successfully Salvage Recurrent Cervical Cancer after CCRT: A Case Report

Wei

Guo

et al. 2021

Current Oncology

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Cervical cancer is the fourth most common cancer in females worldwide. Patients with stage III and IV cervical cancer based on the Federation of Gynecology and Obstetrics (FIGO) classification have higher recurrence rates. Because of organs at risk (OAR) protection and the low indication rate of salvage surgery, the choice of treatment is always challenging. Systemic chemotherapy is palliative and can be performed in conjunction with surgery or radiotherapy; however, it has no significant benefit to survival. Brachytherapy and stereotactic body radiotherapy (SBRT) are characterized by extremely high radiation doses applied to tumor cells while sparing the normal tissues. Several studies have investigated the efficacy of these technologies in recurrent cervical cancer and showed promising results. The immune checkpoint inhibitors approach was also investigated and showed promising results too. Herein, we report a case of a patient with cervical cancer that recurred five months after adjuvant chemotherapy and concurrent chemoradiotherapy. The disease prognosis after interstitial implantation brachytherapy (IIB) was determined. Then, the patient underwent radioactive 125I-seed implantation combined with PD-1 inhibitor treatment. The patient exhibited a partial response after seed implantation, and up to now, the duration of this partial response was 24 months.

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Section: Introductionmentioning

confidence: 74%

Section: Discussionmentioning

confidence: 99%

PD-1 Inhibitor Maintenance Therapy Combined Iodine-125 Seed Implantation Successfully Salvage Recurrent Cervical Cancer after CCRT: A Case Report

Wei

Guo

et al. 2021

Current Oncology

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“…The most unfavorable prognosis is associated with HPV-negativity or integrated form of HPV16/18 DNA, stage III and age up to 30 years. The latter group of patients with high risk of poor outcome may require more aggressive therapy and careful follow-up for recurrence [63].…”

Section: Discussionmentioning

confidence: 99%

“…Potentially, they can be used to identify prognostically unfavorable cases. Currently, there is accumulating evidence of the effectiveness of hyperthermia, as well as immunotherapeutic and targeted drugs in the treatment of advanced and recurrent CC [63,[68][69][70][71]. These approaches can be especially effective for the treatment of patients with locally advanced CC who have a poor prognosis according to our algorithm.…”

Section: Discussionmentioning

confidence: 99%

HPV Status and Individual Characteristics of Human Papillomavirus Infection as Predictors for Clinical Outcome of Locally Advanced Cervical Cancer

Мкртчян

Замулаева

Крикунова

et al. 2021

JPM

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This study is aimed at searching for an informative predictor of the clinical outcome of cervical cancer (CC) patients. The study included 135 patients with locally advanced cervical cancer (FIGO stage II–III) associated with human papillomavirus (HPV) 16/18 types or negative status of HPV infection. Using logistic regression, we analyzed the influence of the treatment method, clinical and morphological characteristics, and the molecular genetic parameters of HPV on the disease free survival (DFS) of patients treated with radiotherapy or chemoradiotherapy. Multivariate analysis revealed three factors that have prognostic significance for DFS, i.e., HPV-related biomarker (HPV-negativity or HPV DNA integration into the cell genome) (OR = 9.67, p = 1.2 × 10−4), stage of the disease (OR = 4.69, p = 0.001) and age (OR = 0.61, p = 0.025). The predictive model has a high statistical significance (p = 5.0 × 10−8; Nagelkirk’s R2 = 0.336), as well as sensitivity (Se = 0.74) and specificity (Sp = 0.75). Thus, simultaneous accounting for the clinical and molecular genetic predictors (stage of the disease, patient age and HPV-related biomarker) makes it possible to effectively differentiate patients with prognostically favorable and unfavorable outcome of the disease.

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“…In all cases, surgery represents the mainstay treatment option [ 2 ], usually, in combination with chemotherapy, that is of particular interest in advanced stages of the disease and in invasive carcinomas such as ovarian tumors [ 3 , 4 ], and, in some cases, radiotherapy. Several immunotherapeutic treatments, including immune checkpoint inhibitors and monoclonal antibodies, have also been approved in the last few years for the treatment of gynecological malignancies, especially for uterine, cervical, and ovarian carcinomas, improving the therapeutic options of these diseases [ 5 , 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Antibody-Antineoplastic Conjugates in Gynecological Malignancies: Current Status and Future Perspectives

2021

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In the last decade, antibody-drug conjugates (ADCs), normally formed by a humanized antibody and a small drug via a chemical cleavable or non-cleavable linker, have emerged as a potential treatment strategy in cancer disease. They allow to get a selective delivery of the chemotherapeutic agents at the tumor level, and, consequently, to improve the antitumor efficacy and, especially to decrease chemotherapy-related toxicity. Currently, nine antibody-drug conjugate-based formulations have been already approved and more than 80 are under clinical trials for the treatment of several tumors, especially breast cancer, lymphomas, and multiple myeloma. To date, no ADCs have been approved for the treatment of gynecological formulations, but many formulations have been developed and have reached the clinical stage, especially for the treatment of ovarian cancer, an aggressive disease with a low five-year survival rate. This manuscript analyzes the ADCs formulations that are under clinical research in the treatment of gynecological carcinomas, specifically ovarian, endometrial, and cervical tumors.

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Current Status of Clinical Trials for Cervical and Uterine Cancer Using Immunotherapy Combined With Radiation

Cited by 38 publications

References 86 publications

PD-1 Inhibitor Maintenance Therapy Combined Iodine-125 Seed Implantation Successfully Salvage Recurrent Cervical Cancer after CCRT: A Case Report

PD-1 Inhibitor Maintenance Therapy Combined Iodine-125 Seed Implantation Successfully Salvage Recurrent Cervical Cancer after CCRT: A Case Report

HPV Status and Individual Characteristics of Human Papillomavirus Infection as Predictors for Clinical Outcome of Locally Advanced Cervical Cancer

Antibody-Antineoplastic Conjugates in Gynecological Malignancies: Current Status and Future Perspectives

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