Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China; Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, China.
Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China.
Int Immunopharmacol. 2024 Mar 10;129:111578. doi: 10.1016/j.intimp.2024.111578. Epub 2024 Feb 7.
Maintenance therapy (MT) for recurrent or metastatic cervical cancer remains non-standardized. This study assessed MT effectiveness using a comprehensive approach and identifies prognosis factors inpatients with recurrent or metastatic cervical cancer.
From January 2019 and December 2021, over 6000 patients from six Chinese institutions were retrospectively examined. Patients had recurrent/metastatic cervical cancer and underwent first-line chemotherapy with or without MT. We calculated overall and progression-free survival using Kaplan-Meier analysis, comparing via log-rank test, and conducted Cox regression for prognostic factors.
Overall, 274 patients were stratified into an MT group (n = 77) and a non-MT group (n = 197). The 3-year OS rates were 52.5 % and 28.0 % for the MT and non-MT groups, respectively. The MT group had significantly enhanced median OS (37 vs. 21 months; HR, 0.43; 95 % CI, 0.30-0.61; P < 0.001) and PFS (21 vs. 14 months; HR, 0.65; 95 % CI, 0.47-0.90; P = 0.014) compared with the non-MT group. No significant differences in efficacy were observed among the various MT regimens, whether PD-1 monoclonal antibody, targeted therapeutic agents, or a combination of both. Extended PFS and OS were observed in patients receiving > 8 MT cycles. Multivariate analyses revealed that oligometastasis, MT, exclusive prior surgery (as opposed to combined surgery and radiotherapy), and extended interval before recurrence were independent OS predictors (P = 0.045, P < 0.001, P = 0.010, and P = 0.005, respectively); oligometastasis, concurrent radiotherapy, MT, and extended interval before recurrence were independent PFS predictors (P = 0.004, P = 0.007, P = 0.009, and P = 0.003).
The MT integration markedly extended PFS and OS in patients diagnosed with recurrent or metastatic cervical cancer.
复发性或转移性宫颈癌的维持治疗（MT）仍然没有标准化。本研究采用综合方法评估 MT 的疗效，并确定复发性或转移性宫颈癌患者的预后因素。
2019 年 1 月至 2021 年 12 月，来自中国 6 家机构的 6000 多名患者进行了回顾性检查。患者患有复发性/转移性宫颈癌，接受了一线化疗联合或不联合 MT。我们使用 Kaplan-Meier 分析计算总生存期和无进展生存期，通过对数秩检验进行比较，并对预后因素进行 Cox 回归分析。
总体而言，274 名患者分为 MT 组（n=77）和非 MT 组（n=197）。MT 组和非 MT 组的 3 年 OS 率分别为 52.5%和 28.0%。MT 组的中位 OS（37 个月比 21 个月；HR，0.43；95%CI，0.30-0.61；P<0.001）和 PFS（21 个月比 14 个月；HR，0.65；95%CI，0.47-0.90；P=0.014）均显著改善。在 PD-1 单克隆抗体、靶向治疗药物或两者联合的不同 MT 方案中，疗效无显著差异。接受>8 个 MT 周期的患者观察到延长的 PFS 和 OS。多变量分析显示，寡转移、MT、单纯手术（与手术和放疗联合相反）和复发前间隔时间延长是 OS 的独立预测因素（P=0.045，P<0.001，P=0.010，P=0.005）；寡转移、同期放疗、MT 和复发前间隔时间延长是 PFS 的独立预测因素（P=0.004，P=0.007，P=0.009，P=0.003）。
MT 联合治疗显著延长了复发性或转移性宫颈癌患者的 PFS 和 OS。
