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Cervical cancer
567 Efficacy of checkpoint inhibitor immunotherapy drug pembrolizumab (KEYTRUDA) for treatment of advanced cervical cancer
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  1. F Ahmed1,
  2. Z Shah2,
  3. I Khan1,
  4. A Bhatnagar1,
  5. R Garimella1,
  6. S Mishra1,
  7. S Gudapati3,
  8. SH Bobba3,
  9. S Zaidi4,
  10. K Andrews5,
  11. U Salman6,
  12. Z Yukselen1,
  13. P Guntipalli1,
  14. R Zarrar7,
  15. G Enebong Nya8 and
  16. S Ahmad9
  1. 1Larkin Community Hospital, Division of Clinical and Translational Research, South Miami, USA
  2. 2Weiss Memorial Hospital, Department of Internal Medicine, Chicago, USA
  3. 3Washington University of Health and Science, College of Medicine, San Pedro, Belize
  4. 4Lahore Medical and Dental College, College of Medicine, Lahore, Pakistan
  5. 5Prince Mohammad Bin Fahad University, Department of CORE, Al Khobar, Saudi Arabia
  6. 6Bakhtawar Amin Medical and Dental College, College of Medicine, Multan, Pakistan
  7. 7Mayo Clinic, Department of Oncology, Rochester, USA
  8. 8John Hopkins Hospital, Department of Gynecologic Oncology, Baltimore, USA
  9. 9Advent Health Cancer Institute, Division of Gynecologic Oncology, Orlando, USA

Abstract

Introduction/Background*Cervical cancer is the fourth most common cause of cancer-related deaths in women worldwide. With screening for precancerous lesions and vaccination for preventive human papillomavirus (HPV), a survival improvement has been observed in these patients in developed countries. In recent years, immunotherapy has represented a breakthrough in oncology and immune-checkpoint inhibitors have shown antitumor activity in a variety of tumor types. Here, we present the first systematic review discussing the efficacy and clinical usefulness of pembrolizumab, an anti-PD-1 checkpoint inhibitor, in the treatment of advanced cervical cancer.

Methodology A systematic literature search was performed on March 2021 according to PRISMA statement using multiple databases and selective medical search terms (MeSH) such as ’uterine cervical neoplasms’ AND ’Pembrolizumab’. After a detailed primary and secondary screening conducted by two members of 188 studies, total 7 studies were included (Chung et al. 2019, Frenel et al. 2017, Choi, M et al. 2020, H Chung et al. 2018, SH Kim al. 2019, J Zhu et al.2019, K. Miller et al. 2020).

Result(s)*A total of 411 patients, mean age of 48 years (21-76) with advanced cervical cancer who had received a median range of 1-7 previous lines of therapies, were included. In all studies, pembrolizumab monotherapy reported a cumulative median duration of follow up of 10.5 months (0-32.2), overall response rate (ORR) of 15% (n=47/313), and complete response of 3.76% (n=14/372). Very Good partial response was not reported in any study. A calculated pooled partial response, stable disease, and progressive disease were reported respectively [9.7%(n=40/411) vs. 19.3% (n=67/346) vs. 41%(n=145/348)]. Six-month overall survival as presented in 3 studies was 67%(n=160/239). The progression free survival and survival data is premature at this stage and requires further elaboration in phase II/III clinical trials.

Conclusion*Pembrolizumab (KEYTRUDA) monotherapy demonstrated durable antitumor activity in patients with advanced cervical cancer. However, further studies using combinations with other treatment options including chemotherapy, radiotherapy and other immunotherapeutic agents should be explored for the efficacy and survival outcomes.

https://doi.org/10.1136/ijgc-2021-ESGO.43

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