Unit:
Κατεύθυνση Κλινικές Μελέτες: Σχεδιασμός και ΕκτέλεσηLibrary of the School of Health Sciences
Supervisors info:
Φλώρα Ζαγουρή, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Ευάγγελος Τέρπος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Ευστάθιος Καστρίτης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Ο ρόλος της ανοσοθεραπείας στον καρκίνο του τραχήλου της μήτρας: συστηματική ανασκόπηση
Translated title:
The role of immunotherapy in cervical cancer: a systematic review
Summary:
Background: Locally advanced cervical cancer is treated with cisplatin and radiotherapy, while metastatic/recurrent disease is treated with a combination of platinum-based chemotherapy and bevacizumab. However, the results are not optimal and the options available are limited for patients who do not respond to these therapies.
Objective: To conduct a systematic review and assess the efficacy and safety of immunotherapy in advanced cervical malignancies.
Methods: PubMed and Embase searches were carried out up to February 2023 for prospective clinical trials (phases I to III) evaluating the role of immunotherapy in patients with advanced, metastatic, or recurrent cervical cancer, including immune checkpoint inhibitors, therapeutic vaccines, and adoptive t-cell therapy (ACT).
Results: Our analysis included 61 clinical trials. Immune checkpoint inhibitors showed promising results with a significant improvement in objective response rate (ORR), overall survival (OS), and progression-free survival (PFS) compared to standard therapy. The ORR of immune checkpoint inhibitors ranged from 0% to 55.6%, while the OS and PFS ranged from 11 to 14.72 months and 2 to 9.4 months, respectively. Novel anti-PD-1 antibodies were found to be the most effective when combined with tyrosine kinase inhibitors. The observed disparities in effectiveness were attributed to variations in the pharmacokinetics/pharmacodynamics of the drugs, their ability to engage more than one immune checkpoint simultaneously, and the differences between the patient groups. Peptide vaccines, due to their ability to target specific cancer antigens and/or mutations, were found to be superior to other vaccine platforms, with fewer adverse reactions. ACT, particularly with tumor-infiltrating lymphocytes, showed high ORR and potential long-term remission when combined with other immune checkpoint inhibitors or chemoradiation. Despite some patients experiencing high-grade adverse events, these were still tolerable with low discontinuation rates, and no treatment-related deaths or autoimmune reactions were reported.
Conclusion: Immunotherapy is an effective and well-tolerated option for cervical cancer patients. Further research is required to better understand the varying efficacy of combining different immunotherapeutic agents.
Main subject category:
Health Sciences
Keywords:
Cervical cancer, Immunotherapy, Immune checkpoint inhibitors, Therapeutic vaccines, Adoptive T-cell therapy
Number of references:
285
File:
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Pagkali_Antonia_MSc.pdf
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File access is restricted only to the intranet of UoA.
Pagkali_Antonia_MSc Supplementary Material.pdf
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