The current status of immunotherapy for cervical cancer

• Published in: Reports of practical oncology and radiotherapy Vol. 23; no. 6; pp. 580 - 588
• Main Authors: Orbegoso, Cecilia, Murali, Krithika, Banerjee, Susana
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Sp. z o.o 01-11-2018; Elsevier
• Subjects: Adoptive T cell therapy; Cervical cancer; Human papillomavirus; Immune checkpoints inhibitors; Special issue paper; Therapeutic vaccines; TCR; RNA; CD4, -8, -80; FIGO; LLO; ORR; HPV; DFS; Human papillomavirus; Immune checkpoints inhibitors; TRAEs; ILT's; SLP; Therapeutic vaccines; PD-L1; CTLA-4; PFS; Lm; OS; Adoptive T cell therapy; IL-2; MCH; APC; CAR; DNA; TGFβ; CTL; TILs; HLA; PD-1; MAGE-A3; Cervical cancer; DC; TCR, T-cell receptor; IL-2, interleukin 2; DC, dendritic cell; ILT's, Ig-like transcripts; PD-L1, programmed death-ligand 1; ORR, objective response rate; MAGE-A3, melanoma-associated antigen 3; Lm, Listeria monocytogenes; CD4, -8, -80, cluster of differentiation 4, -8, -80; APC, antigen-presenting cell; LLO, listerolysin O; DNA, deoxyribonucleic acid; HPV, human papilloma virus; RNA, ribonucleic acid; CTLA-4, cytotoxic T-lymphocyte-associated protein 4; FIGO, International Federation of Gynecology and Obstetrics; DFS, disease free survival; TGFβ, transforming growth factor beta; PFS, progression free survival; CAR, chimeric antigen receptor; CTL, cytotoxic-T lymphocyte; OS, overall survival; TILs, tumor-infiltrating lymphocytes; HLA, human leucocyte antigen; MCH, major histocompatibility complex; SLP, synthetic long-peptide; PD-1, programmed cell death protein 1; TRAEs, treatment related adverse events
• ISSN: 1507-1367; 2083-4640
• DOI: 10.1016/j.rpor.2018.05.001

Immunotherapy has been proven effective in several tumours, hence diverse immune checkpoint inhibitors are currently licensed for the treatment of melanoma, kidney cancer, lung cancer and most recently, tumours with microsatellite instability. There is much enthusiasm for investigating this approach in gynaecological cancers and the possibility that immunotherapy might become part of the therapeutic landscape for gynaecological malignancies.
Cervical cancer is the fourth most frequent cancer in women worldwide and represents 7.9% of all female cancers with a higher burden of the disease and mortality in low- and middle-income countries. Cervical cancer is largely a preventable disease, since the introduction of screening tests, the recognition of the human papillomavirus (HPV) as an etiological agent, and the subsequent development of primary prophylaxis against high risk HPV subtypes. Treatment for relapsed/advanced disease has improved over the last 5 years, since the introduction of antiangiogenic therapy. However, despite advances, the median overall survival for advanced cervical cancer is 16.8 months and the 5-year overall survival for all stages is 68%. There is a need to improve outcomes and immunotherapy could offer this possibility. Clinical trials aim to understand the best timing for immunotherapy, either in the adjuvant setting or recurrent disease and whether immunotherapy, alone or in combination with other agents, improves outcomes.