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西米普利单抗治疗复发性宫颈癌:III期EMPOWER-Cervical 1/GOG-3016/ENGOT-cx9试验总生存期的最终分析

Cemiplimab in recurrent cervical cancer: Final analysis of overall survival in the phase III EMPOWER-Cervical 1/GOG-3016/ENGOT-cx9 trial.

作者信息

Oaknin Ana, Monk Bradley J, de Melo Andreia Cristina, Kim Hee Seung, Kim Yong Man, Lisyanskaya Alla S, Samouëlian Vanessa, Lorusso Domenica, Damian Fernanda, Chang Chih-Long, Gotovkin Evgeniy, Takahashi Shunji, Ramone Daniella, Maćkowiak-Matejczyk Beata, Polastro Laura, Alia Eva Maria Guerra, Colombo Nicoletta, Makarova Yulia, Goh Jeffrey C, Hasegawa Kosei, Mora Paulo, Pikiel Joanna, Srivastav Ratnesh, Rischin Danny, Rubio Maria Jesús, Perez Javier, Yoo Suk Young, Gao Bo, Jamil Shaheda, Seebach Frank, Lowy Israel, Mathias Melissa, Fury Matthew G, Tewari Krishnansu S

机构信息

Medical Oncology Service, Vall d'Hebron Institute of Oncology, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain.

Florida Cancer Specialists and Research Institute, West Palm Beach, FL, USA.

出版信息

Eur J Cancer. 2025 Feb 5;216:115146. doi: 10.1016/j.ejca.2024.115146. Epub 2025 Jan 10.

Abstract

AIM

Cemiplimab has demonstrated significantly longer survival than physician's choice of chemotherapy in patients with recurrent cervical cancer after first-line platinum-containing chemotherapy. We report the final survival analysis from the phase III randomized study (EMPOWER-Cervical 1/GOG-3016/ENGOT-cx9).

METHODS

Cemiplimab (n = 304) or chemotherapy (n = 304) were administered every 3 weeks. The primary endpoint was overall survival (OS). Patients were included regardless of programmed cell death-ligand 1 (PD-L1) status.

RESULTS

At a median follow-up of 47.3 months (data cut-off: April 20, 2023), median OS was 11.7 versus 8.5 months for patients treated with cemiplimab and chemotherapy, respectively (hazard ratio 0.67, 95 % confidence interval 0.56-0.80, p < .00001). OS benefit was seen in PD-L1 positive and negative populations, even though more patients with PD-L1 < 1 % (n = 92), had poor performance status in the cemiplimab arm than the chemotherapy arm (61.4 % vs 47.9 %).

CONCLUSION

This final analysis confirms that cemiplimab maintains survival benefit compared with chemotherapy in recurrent cervical cancer after progression on first-line platinum therapy, regardless of PD-L1 expression. The safety profile was consistent with published data; incidences of adverse events were similar between cemiplimab and chemotherapy groups. These results support the use of second-line cemiplimab for patients with recurrent cervical cancer.

摘要

目的

在一线含铂化疗后的复发性宫颈癌患者中,西米普利单抗已显示出比医生选择的化疗方案具有显著更长的生存期。我们报告了III期随机研究(EMPOWER-Cervical 1/GOG-3016/ENGOT-cx9)的最终生存分析结果。

方法

每3周给予西米普利单抗(n = 304)或化疗(n = 304)。主要终点为总生存期(OS)。纳入患者时不考虑程序性细胞死亡配体1(PD-L1)状态。

结果

在中位随访47.3个月(数据截止日期:2023年4月20日)时,接受西米普利单抗和化疗的患者的中位总生存期分别为11.7个月和8.5个月(风险比0.67,95%置信区间0.56 - 0.80,p <.00001)。在PD-L1阳性和阴性人群中均观察到总生存期获益,尽管在西米普利单抗组中,PD-L1 < 1%的患者(n = 92)中,身体状况较差的患者比例高于化疗组(61.4%对47.9%)。

结论

该最终分析证实,在一线铂类治疗进展后的复发性宫颈癌中,无论PD-L1表达如何,与化疗相比,西米普利单抗均能维持生存获益。安全性概况与已发表数据一致;西米普利单抗组和化疗组不良事件的发生率相似。这些结果支持将二线西米普利单抗用于复发性宫颈癌患者。

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