Thyroid disorders as predictors of cemiplimab efficacy in recurrent/metastatic cervical cancer: real-world evidence from Poland

IntroductionImmune checkpoint inhibitors have improved survival in patients with recurrent or metastatic cervical cancer (r/mCC), yet reliable predictors of treatment efficacy remain undefined. Immune-related adverse events (irAEs) have been suggested as potential predictors of response, but evidenc...

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Main Authors: Renata Pacholczak-Madej, Maja Lisik-Habib, Radosław Mądry, Monika Szarszewska, Zuzanna Borysiewicz, Katarzyna Gabalewicz, Ewa Iwańska, Wiktor Szatkowski, Mirosława Puskulluoglu, Jerzy Jakubowicz, Paweł Blecharz
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Immunology
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Online Access:https://www.frontiersin.org/articles/10.3389/fimmu.2025.1604826/full
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author Renata Pacholczak-Madej
Renata Pacholczak-Madej
Maja Lisik-Habib
Radosław Mądry
Monika Szarszewska
Zuzanna Borysiewicz
Katarzyna Gabalewicz
Ewa Iwańska
Wiktor Szatkowski
Mirosława Puskulluoglu
Jerzy Jakubowicz
Paweł Blecharz
author_facet Renata Pacholczak-Madej
Renata Pacholczak-Madej
Maja Lisik-Habib
Radosław Mądry
Monika Szarszewska
Zuzanna Borysiewicz
Katarzyna Gabalewicz
Ewa Iwańska
Wiktor Szatkowski
Mirosława Puskulluoglu
Jerzy Jakubowicz
Paweł Blecharz
author_sort Renata Pacholczak-Madej
collection DOAJ
description IntroductionImmune checkpoint inhibitors have improved survival in patients with recurrent or metastatic cervical cancer (r/mCC), yet reliable predictors of treatment efficacy remain undefined. Immune-related adverse events (irAEs) have been suggested as potential predictors of response, but evidence in cervical cancer is limited.MethodsWe conducted an ambispective, multicenter observational study of 37 patients with r/mCC treated with cemiplimab within Poland’s national rescue access program. Baseline characteristics, treatment outcomes, and irAEs were analyzed. Survival outcomes were estimated using the Kaplan–Meier method and compared using Cox proportional hazards models. A p-value of <0.05 was considered statistically significant.ResultsAfter a median follow-up of 9.2 months, 17 episodes of irAEs were reported in 40.5% of patients (n=15), with thyroid disorders being the most common (n=11, 64.7%). Patients who developed ir-thyroid disorders had significantly longer progression-free survival (hazard ratio [HR]=0.2; 95% confidence interval [CI]: 0.07–0.6, p=0.004) and overall survival (HR=0.2; 95% CI: 0.05–0.9; p=0.04) compared to those without such events. Moreover, the objective response rate was notably higher in this group (45.5% versus 11.5%, p=0.04). Most irAEs were mild and manageable, with a median time to onset of two months after cemiplimab initiation.ConclusionsIr-thyroid disorders may indicate enhanced immune activation and represent a potential surrogate of cemiplimab efficacy in r/mCC, although validation in larger cohorts is required.
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spelling doaj-art-fee07211f4e04d8dab3527dd72e2fd932025-08-20T02:09:28ZengFrontiers Media S.A.Frontiers in Immunology1664-32242025-06-011610.3389/fimmu.2025.16048261604826Thyroid disorders as predictors of cemiplimab efficacy in recurrent/metastatic cervical cancer: real-world evidence from PolandRenata Pacholczak-Madej0Renata Pacholczak-Madej1Maja Lisik-Habib2Radosław Mądry3Monika Szarszewska4Zuzanna Borysiewicz5Katarzyna Gabalewicz6Ewa Iwańska7Wiktor Szatkowski8Mirosława Puskulluoglu9Jerzy Jakubowicz10Paweł Blecharz11Department of Gynecological Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Krakow, PolandDepartment of Anatomy, Jagiellonian University, Medical College, Krakow, PolandDepartment of Proliferative Diseases, Copernicus Memorial Hospital in Lodz Comprehensive Cancer Center and Traumatology, Łódź, PolandKlinika Ginekologii Onkologicznej Uniwersytetu Medycznego w Poznaniu, Poznan, PolandKlinika Ginekologii Onkologicznej Uniwersytetu Medycznego w Poznaniu, Poznan, PolandDepartment of Oncology and Chemotherapy, Provincial Integrated Hospital, Elbląg, PolandLower Silesian Oncology, Pulmonology and Hematology Center, Wrocław, PolandDepartment of Gynecological Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Krakow, PolandDepartment of Gynecological Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Krakow, PolandDepartment of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Krakow, PolandDepartment of Gynecological Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Krakow, PolandDepartment of Gynecological Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Krakow, PolandIntroductionImmune checkpoint inhibitors have improved survival in patients with recurrent or metastatic cervical cancer (r/mCC), yet reliable predictors of treatment efficacy remain undefined. Immune-related adverse events (irAEs) have been suggested as potential predictors of response, but evidence in cervical cancer is limited.MethodsWe conducted an ambispective, multicenter observational study of 37 patients with r/mCC treated with cemiplimab within Poland’s national rescue access program. Baseline characteristics, treatment outcomes, and irAEs were analyzed. Survival outcomes were estimated using the Kaplan–Meier method and compared using Cox proportional hazards models. A p-value of <0.05 was considered statistically significant.ResultsAfter a median follow-up of 9.2 months, 17 episodes of irAEs were reported in 40.5% of patients (n=15), with thyroid disorders being the most common (n=11, 64.7%). Patients who developed ir-thyroid disorders had significantly longer progression-free survival (hazard ratio [HR]=0.2; 95% confidence interval [CI]: 0.07–0.6, p=0.004) and overall survival (HR=0.2; 95% CI: 0.05–0.9; p=0.04) compared to those without such events. Moreover, the objective response rate was notably higher in this group (45.5% versus 11.5%, p=0.04). Most irAEs were mild and manageable, with a median time to onset of two months after cemiplimab initiation.ConclusionsIr-thyroid disorders may indicate enhanced immune activation and represent a potential surrogate of cemiplimab efficacy in r/mCC, although validation in larger cohorts is required.https://www.frontiersin.org/articles/10.3389/fimmu.2025.1604826/fullcemiplimabuterine cervical neoplasmsthyroid diseasesimmune checkpoint inhibitorsimmune-related adverse events
spellingShingle Renata Pacholczak-Madej
Renata Pacholczak-Madej
Maja Lisik-Habib
Radosław Mądry
Monika Szarszewska
Zuzanna Borysiewicz
Katarzyna Gabalewicz
Ewa Iwańska
Wiktor Szatkowski
Mirosława Puskulluoglu
Jerzy Jakubowicz
Paweł Blecharz
Thyroid disorders as predictors of cemiplimab efficacy in recurrent/metastatic cervical cancer: real-world evidence from Poland
Frontiers in Immunology
cemiplimab
uterine cervical neoplasms
thyroid diseases
immune checkpoint inhibitors
immune-related adverse events
title Thyroid disorders as predictors of cemiplimab efficacy in recurrent/metastatic cervical cancer: real-world evidence from Poland
title_full Thyroid disorders as predictors of cemiplimab efficacy in recurrent/metastatic cervical cancer: real-world evidence from Poland
title_fullStr Thyroid disorders as predictors of cemiplimab efficacy in recurrent/metastatic cervical cancer: real-world evidence from Poland
title_full_unstemmed Thyroid disorders as predictors of cemiplimab efficacy in recurrent/metastatic cervical cancer: real-world evidence from Poland
title_short Thyroid disorders as predictors of cemiplimab efficacy in recurrent/metastatic cervical cancer: real-world evidence from Poland
title_sort thyroid disorders as predictors of cemiplimab efficacy in recurrent metastatic cervical cancer real world evidence from poland
topic cemiplimab
uterine cervical neoplasms
thyroid diseases
immune checkpoint inhibitors
immune-related adverse events
url https://www.frontiersin.org/articles/10.3389/fimmu.2025.1604826/full
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