Frontiers in immunology · 2026
Neoadjuvant chemotherapy and immunotherapy followed by radical radiotherapy for locally advanced cervical cancer: efficacy and safety.
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Wei Qianxue, Qu Hui, Yu Yatong, Gao Song, Jia Yuxin, Xia Yu, Li Xiuqin, Gu Wen
Аннотация
OBJECTIVE: This study aimed to evaluate the short-term efficacy and safety of neoadjuvant chemoimmunotherapy (NACI) followed by radical radiotherapy (RR) in patients with locally advanced cervical cancer (LACC).
METHODS: A retrospective analysis was conducted on 60 patients with FIGO 2018 stage IIIA-IVA cervical cancer between June 2022 and July 2024. The experimental group (n=30) received 1-3 cycles of NACI (anti-PD-1/PD-L1 therapy plus platinum-based chemotherapy) followed by RR, which was administered either alone or concurrently with immunotherapy/chemotherapy. The control group (n=30) received RR with or without concurrent chemotherapy. Treatment response was assessed using RECIST 1.1 incorporating gynecological examination.
RESULTS: After NACI, the objective response rate (ORR) was 93.3% in the experimental group, increasing to 100% post-radiotherapy. The complete response (CR) rate was comparable between groups (90.0% vs. 86.7%, P = 1.000). With a median follow-up of 20.5 months, the 2-year progression-free survival (PFS) was significantly higher in the experimental group (82.5% vs. 66.0%; HR = 0.364, P = 0.0303), though overall survival (OS) did not differ significantly. The experimental group had a significantly lower incidence of radiotherapy-related intestinal toxicity (20% vs. 60%, P = 0.0033). All immune-related adverse events were grade 1-2.
CONCLUSION: For high-risk LACC, NACI followed by RR was associated with a significantly lower incidence of radiotherapy-related intestinal toxicity. A potential PFS benefit was also observed, although its independent effect could not be confirmed in this limited sample. These findings warrant further investigation in larger prospective trials.
METHODS: A retrospective analysis was conducted on 60 patients with FIGO 2018 stage IIIA-IVA cervical cancer between June 2022 and July 2024. The experimental group (n=30) received 1-3 cycles of NACI (anti-PD-1/PD-L1 therapy plus platinum-based chemotherapy) followed by RR, which was administered either alone or concurrently with immunotherapy/chemotherapy. The control group (n=30) received RR with or without concurrent chemotherapy. Treatment response was assessed using RECIST 1.1 incorporating gynecological examination.
RESULTS: After NACI, the objective response rate (ORR) was 93.3% in the experimental group, increasing to 100% post-radiotherapy. The complete response (CR) rate was comparable between groups (90.0% vs. 86.7%, P = 1.000). With a median follow-up of 20.5 months, the 2-year progression-free survival (PFS) was significantly higher in the experimental group (82.5% vs. 66.0%; HR = 0.364, P = 0.0303), though overall survival (OS) did not differ significantly. The experimental group had a significantly lower incidence of radiotherapy-related intestinal toxicity (20% vs. 60%, P = 0.0033). All immune-related adverse events were grade 1-2.
CONCLUSION: For high-risk LACC, NACI followed by RR was associated with a significantly lower incidence of radiotherapy-related intestinal toxicity. A potential PFS benefit was also observed, although its independent effect could not be confirmed in this limited sample. These findings warrant further investigation in larger prospective trials.