Article Text
Abstract
Introduction/Background As several cases of complete response in patients with advanced or recurrent cervical cancer using Pembrolizumab were reported, immunochemotherapy come into the spotlight as one method of treating cervical cancer. The aim of this study was to investigate the real world efficacy of Pembrolizumab in advanced or recurrent cervical cancer.
Methodology Cervical cancer Patients who treated by Pembrolizumab at Asan Medical Center in Korea between May 2018 and April 2019 were identified, and their medical records were reviewed retrospectively. We assessed Programmed cell death ligand 1 (PD-L1) in patients whose cell type was adenocarcinoma (ADCA) or adenosquamous cell carcinoma (ASCC). ADCA or ASCC patients whose PD-L1 was positive, and squamous cell carcinoma (SCC) patients regardless of PD-L1 used Pembrolizumab. Pembrolizumab 200 mg was administered intravenously every 3weeks. Best tumour response was assessed using RECIST v1.1 and iRECIST.
Results Of the 15 patients, 11 (73.3%) patents had SCC. 2 (13.3%), 2 (13.3%) patients had ADCA and ASCC respectively. 4 (26.7%) patients were unable to assess the tumour response, because their condition deteriorated after using Pembrolizumab 1 or 2 times. 2 (13.3%) patients are waiting for follow up computed topography exam after using Pembrolizumab. Therefore, tumour response can be assessed only in 9 (60%) patients. Of these 9 patients, partial response (PR) was showed in just 1 patient. Stable disease (SD) was showed in other 1 patient, and the others were showing progressive disease (PD). Objective response rate was 11.1% and clinical benefit rate was 22.2%. A patient who showed PR had high tumour proportion score (TPS) (90%).
Conclusion Pembrolizumab can be effective when administered in patients with high TPS. The effects were minimal for patients with PD-L1 negative or low TPS, and PD was often observed. Therefore, adequate patient selection is most crucial before using Pembrolizumab. The necessity of large-scaled multicenter retrospective study was highly required.
Disclosure Nothing to disclose.