Faculty of Medicine, Doctorate Program in Medical, Dental and Health Sciences, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico.
Department of Clinical Research, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico.
Rev Invest Clin. 2020;72(4):231-238. doi: 10.24875/RIC.20000060.
Cervical cancer (CC) is one of the most common gynecological tumors and an important health problem, especially in developing countries. The vast majority of patients in early stages are cured of the disease with surgical treatment and with concomitant chemoradiotherapy in locally advanced stages. However, in patients with recurrent, persistent, or metastatic cervical CC, the effectiveness of treatment is limited, except for the combination of chemotherapy based on platinum doublets plus bevacizumab, the treatment that has achieved the best results to date. Programmed cell death-1/PD ligand-1 (PD-1/PD-L1) inhibitors could be a novel and cutting-edge therapeutic option to improve clinical outcomes in this group of patients. Thus far, there are a few Phase I/II clinical trials that have assessed the usefulness of pembrolizumab and nivolumab in this group of patients; these include the KEYNOTE 028, KEYNOTE 158, and CHECKMATE 358 trials, in which clinical benefit has been proven with PD-1/PD-L1 inhibitors in recurrent, persistent, or metastatic CC, as second-line treatment. There are also some ongoing trials that could provide further evidence on the PD-1/PD-L1 pathway as a therapeutic target in CC. In this review, we will focus on the usefulness of these PD-1/PDL1 inhibitors in CC, as well as on trials that are still in the recruitment phase, to confirm their effectiveness in this clinical setting.
宫颈癌（CC）是最常见的妇科肿瘤之一，也是一个重要的健康问题，特别是在发展中国家。绝大多数早期患者通过手术治疗，局部晚期患者辅以同步放化疗，可以治愈疾病。然而，对于复发性、持续性或转移性宫颈癌患者，除了以铂类为基础的双联化疗加贝伐珠单抗的联合治疗取得了迄今为止最好的效果外，治疗的有效性有限。程序性细胞死亡-1/PD 配体-1（PD-1/PD-L1）抑制剂可能是改善这组患者临床结局的一种新颖和前沿的治疗选择。迄今为止，已经有一些 I/II 期临床试验评估了派姆单抗和纳武利尤单抗在这组患者中的应用，包括 KEYNOTE 028、KEYNOTE 158 和 CHECKMATE 358 试验，这些试验证明了 PD-1/PD-L1 抑制剂在复发性、持续性或转移性宫颈癌二线治疗中的临床获益。还有一些正在进行的试验可能会为 PD-1/PD-L1 通路作为宫颈癌治疗靶点提供更多证据。在这篇综述中，我们将重点关注这些 PD-1/PDL1 抑制剂在宫颈癌中的应用，并关注仍在招募阶段的试验，以确认它们在这一临床环境中的有效性。
