Jin Ge, Wang Jun
1 Department of Gynecologic Oncology, Fourth Hospital of Hebei Medical University, Shijiazhuang, China.
Department of Radiation Oncology, Fourth Hospital of Hebei Medical University, Shijiazhuang, China.
Front Immunol. 2025 Apr 7;16:1542795. doi: 10.3389/fimmu.2025.1542795. eCollection 2025.
The therapeutic landscape for recurrent or metastatic cervical cancer remains limited, with few options available. According to National Comprehensive Cancer Network (NCCN) guidelines, pembrolizumab combined with chemotherapy, with or without bevacizumab, is recommended for affected patients. Despite these guidelines, recurrence rates remain elevated, and survival outcomes following standard interventions are unsatisfactory. Furthermore, real-world management of recurrent or metastatic cervical cancer presents inherent complexities, often requiring an integrative, multidimensional treatment approach to enhance long-term survival. The pressing need to refine and adopt multimodal therapeutic strategies is evident in addressing the persistent challenges associated with disease recurrence and progression.
The case involved a 40-year-old female diagnosed with advanced cervical cancer who underwent radical hysterectomy. Postoperative pathology identified high-risk features, including lymph node involvement, necessitating adjuvant chemoradiotherapy. However, disease progression occurred during treatment, manifesting as metastases in the left supraclavicular and axillary lymph nodes. Subsequent local radiotherapy and systemic therapy led to a favorable response. By November 2024, overall survival (OS) had surpassed 72 months, with toripalimab administered for 65 months, during which no immunotherapy-related adverse events occurred.
This case offers clinical insight into the efficacy and safety of integrating chemotherapy, immunotherapy, and radiotherapy in recurrent or metastatic cervical cancer. The multimodal approach contributes to prolonged survival in this patient. Further clinical trials are essential to substantiate the therapeutic benefits of this regimen in broader patient cohorts.
复发性或转移性宫颈癌的治疗选择仍然有限。根据美国国立综合癌症网络(NCCN)指南,帕博利珠单抗联合化疗(联合或不联合贝伐单抗)被推荐用于此类患者。尽管有这些指南,但复发率仍然很高,标准干预后的生存结果并不理想。此外,复发性或转移性宫颈癌的实际治疗存在内在复杂性,通常需要综合、多维度的治疗方法来提高长期生存率。在应对与疾病复发和进展相关的持续挑战方面,完善和采用多模式治疗策略的迫切需求显而易见。
该病例为一名40岁女性,被诊断为晚期宫颈癌,接受了根治性子宫切除术。术后病理显示存在高危特征,包括淋巴结受累,因此需要进行辅助放化疗。然而,治疗期间疾病进展,表现为左锁骨上和腋窝淋巴结转移。随后的局部放疗和全身治疗产生了良好的反应。截至2024年11月,总生存期(OS)已超过72个月,替雷利珠单抗使用了65个月,在此期间未发生免疫治疗相关不良事件。
该病例为复发性或转移性宫颈癌综合化疗、免疫治疗和放疗的疗效和安全性提供了临床见解。这种多模式方法有助于延长该患者的生存期。进一步的临床试验对于证实该方案在更广泛患者群体中的治疗益处至关重要。