The efficacy of first and second immunotherapy exposure in patients with recurrent or metastatic cervical cancer

Abstract Objective Immunotherapy has led to changes in cervical cancer guidelines. Therefore, additional biomarkers to identify the ideal patient who would experience the most benefit may be important. Methods We retrospectively collected 208 patients with R/M CC and recorded clinicopathologic infor...

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Main Authors: Mingxiu Ju, Baoyue Pan, Yongwen Huang, Yun Zhou, Jieping Chen, Huiling Xiang, Shije Xu, Siyu Chen, Chunyan Lan, Jundong Li, Min Zheng
Format: Article
Language:English
Published: Wiley 2024-10-01
Series:Cancer Medicine
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Online Access:https://doi.org/10.1002/cam4.70204
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author Mingxiu Ju
Baoyue Pan
Yongwen Huang
Yun Zhou
Jieping Chen
Huiling Xiang
Shije Xu
Siyu Chen
Chunyan Lan
Jundong Li
Min Zheng
author_facet Mingxiu Ju
Baoyue Pan
Yongwen Huang
Yun Zhou
Jieping Chen
Huiling Xiang
Shije Xu
Siyu Chen
Chunyan Lan
Jundong Li
Min Zheng
author_sort Mingxiu Ju
collection DOAJ
description Abstract Objective Immunotherapy has led to changes in cervical cancer guidelines. Therefore, additional biomarkers to identify the ideal patient who would experience the most benefit may be important. Methods We retrospectively collected 208 patients with R/M CC and recorded clinicopathologic information, peripheral blood markers and treatments to analyze the prognostic factors of clinical outcomes. Response rate comparison, univariate, and multivariate analyses were performed to assess the efficacy of different factors. Results A total of 43.27% patients achieved objective responses, including 18 with complete response and 72 with partial response. Patients receiving first‐line immunotherapy had much higher objective response rate (ORR) than the remaining patients (53.8% vs. 34.8%, p = 0.006). CRP >3 ECOG ≥1 and recurrence in 6 months predicted shorter progression free survival (PFS). CRP >3, GLU >6.1 independently predicted unfavorable overall survival (OS). Compared with no antiangiogenic therapy, previous antiangiogenic therapy reduced the median OS by nearly 14 months. Immunotherapy rechallenge was still effective after first immunotherapy failure, and combined with dual‐immunotherapy or bevacizumab combined with chemoradiotherapy resulted in a 60.00% or 62.50% ORR, respectively. Patients with squamous cell carcinoma, with stable disease or objective response in the first immunotherapy or without chemotherapy in second immunotherapy had favorable clinical outcome. Conclusion The baseline CRP levels in serum was an independent factor for PFS and OS of R/M CC patients treated with immunotherapy, and previous antiangiogenic therapy was associated with poor OS. Patients still show response to immunotherapy rechallenge and combined treatment with bevacizumab or candonilimab showed higher response rate than anti‐PD‐1 after immunotherapy failure.
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spelling doaj-art-9d7c0956f70d4f7788a6d3283a9a72432025-08-20T03:07:58ZengWileyCancer Medicine2045-76342024-10-011319n/an/a10.1002/cam4.70204The efficacy of first and second immunotherapy exposure in patients with recurrent or metastatic cervical cancerMingxiu Ju0Baoyue Pan1Yongwen Huang2Yun Zhou3Jieping Chen4Huiling Xiang5Shije Xu6Siyu Chen7Chunyan Lan8Jundong Li9Min Zheng10Department of Gynecology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer Sun Yat‐sen University Cancer Center Guangzhou P.R. ChinaDepartment of Gynecology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer Sun Yat‐sen University Cancer Center Guangzhou P.R. ChinaDepartment of Gynecology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer Sun Yat‐sen University Cancer Center Guangzhou P.R. ChinaDepartment of Gynecology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer Sun Yat‐sen University Cancer Center Guangzhou P.R. ChinaDepartment of Gynecology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer Sun Yat‐sen University Cancer Center Guangzhou P.R. ChinaDepartment of Gynecology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer Sun Yat‐sen University Cancer Center Guangzhou P.R. ChinaDepartment of Gynecology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer Sun Yat‐sen University Cancer Center Guangzhou P.R. ChinaDepartment of Gynecology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer Sun Yat‐sen University Cancer Center Guangzhou P.R. ChinaDepartment of Gynecology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer Sun Yat‐sen University Cancer Center Guangzhou P.R. ChinaDepartment of Gynecology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer Sun Yat‐sen University Cancer Center Guangzhou P.R. ChinaDepartment of Gynecology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer Sun Yat‐sen University Cancer Center Guangzhou P.R. ChinaAbstract Objective Immunotherapy has led to changes in cervical cancer guidelines. Therefore, additional biomarkers to identify the ideal patient who would experience the most benefit may be important. Methods We retrospectively collected 208 patients with R/M CC and recorded clinicopathologic information, peripheral blood markers and treatments to analyze the prognostic factors of clinical outcomes. Response rate comparison, univariate, and multivariate analyses were performed to assess the efficacy of different factors. Results A total of 43.27% patients achieved objective responses, including 18 with complete response and 72 with partial response. Patients receiving first‐line immunotherapy had much higher objective response rate (ORR) than the remaining patients (53.8% vs. 34.8%, p = 0.006). CRP >3 ECOG ≥1 and recurrence in 6 months predicted shorter progression free survival (PFS). CRP >3, GLU >6.1 independently predicted unfavorable overall survival (OS). Compared with no antiangiogenic therapy, previous antiangiogenic therapy reduced the median OS by nearly 14 months. Immunotherapy rechallenge was still effective after first immunotherapy failure, and combined with dual‐immunotherapy or bevacizumab combined with chemoradiotherapy resulted in a 60.00% or 62.50% ORR, respectively. Patients with squamous cell carcinoma, with stable disease or objective response in the first immunotherapy or without chemotherapy in second immunotherapy had favorable clinical outcome. Conclusion The baseline CRP levels in serum was an independent factor for PFS and OS of R/M CC patients treated with immunotherapy, and previous antiangiogenic therapy was associated with poor OS. Patients still show response to immunotherapy rechallenge and combined treatment with bevacizumab or candonilimab showed higher response rate than anti‐PD‐1 after immunotherapy failure.https://doi.org/10.1002/cam4.70204antiangiogenic therapyimmunotherapyrecurrent or metastatic cervical cancer
spellingShingle Mingxiu Ju
Baoyue Pan
Yongwen Huang
Yun Zhou
Jieping Chen
Huiling Xiang
Shije Xu
Siyu Chen
Chunyan Lan
Jundong Li
Min Zheng
The efficacy of first and second immunotherapy exposure in patients with recurrent or metastatic cervical cancer
Cancer Medicine
antiangiogenic therapy
immunotherapy
recurrent or metastatic cervical cancer
title The efficacy of first and second immunotherapy exposure in patients with recurrent or metastatic cervical cancer
title_full The efficacy of first and second immunotherapy exposure in patients with recurrent or metastatic cervical cancer
title_fullStr The efficacy of first and second immunotherapy exposure in patients with recurrent or metastatic cervical cancer
title_full_unstemmed The efficacy of first and second immunotherapy exposure in patients with recurrent or metastatic cervical cancer
title_short The efficacy of first and second immunotherapy exposure in patients with recurrent or metastatic cervical cancer
title_sort efficacy of first and second immunotherapy exposure in patients with recurrent or metastatic cervical cancer
topic antiangiogenic therapy
immunotherapy
recurrent or metastatic cervical cancer
url https://doi.org/10.1002/cam4.70204
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