After a median follow-up of 10.2 months, the objective response rate was 12.2% (3 complete and 9 partial responses, all in patients with PD-L1–positive tumors). The trial included 98 women with previously treated, advanced cervical cancer. The first important study of a checkpoint inhibitor was KEYNOTE-158, a phase 2 basket trial that looked at the use of the checkpoint inhibitor pembrolizumab (Keytruda, Merck) as second-line therapy in a variety of cancer types. Therefore, developing more generalizable and practical immunotherapies became a high priority. The risks of treatment include lymphodepletion-associated cytopenias and cytokine release syndrome. This therapy is selective, however a large tumor biopsy specimen is required to obtain the tumor-specific TILs, and it takes time to expand the TILs in vitro (approximately 22 days). The inception of HPV tumor-infiltrating lymphocyte (TIL) therapy was the beginning of treatment-intent immunotherapy TIL therapy induced a complete and durable response in heavily pretreated patients at the National Institutes of Health and was then expanded commercially. It is approved for all individuals starting at 9 years of age and extending up to 45 years of age, although it is most effective before sexual debut. The HPV vaccine now covers 9 serotypes of HPV. LR The most important immunotherapy against cervical cancer is preventative. H&O What are the most important studies to look at immunotherapy in patients with recurrent or metastatic cervical cancer? In addition, it is less associated with the formation of fistulas, which can have a dramatic adverse effect on quality of life. First, it seems to benefit patients with previous radiation as much as it benefits patients who are radiotherapy-naive. Immunotherapy offers several advantages over chemotherapy. In fact, immunotherapy is being used in addition to bevacizumab in the management of cervical cancer, rather than replacing it. Despite this caveat, bevacizumab remains an important addition to chemotherapy in well-selected patients, even those with prior pelvic radiation. Because most patients who need bevacizumab have received prior radiotherapy, this group might have an elevated risk for severe adverse events, with a smaller magnitude of benefit. In addition, an exploratory analysis by Tewari and colleagues of the Gynecologic Oncology Group (GOG) 240 registration trial of bevacizumab in this setting reported a greater magnitude of benefit from bevacizumab in patients who had not received prior pelvic radiation. Unfortunately, this combination can be associated with an increased risk for fistula formation, typically in patients who have received prior radiotherapy. LR The addition of bevacizumab to chemotherapy was an important advance in the treatment of patients with recurrent or metastatic cervical cancer. H&O What are the shortcomings of non-immunotherapy treatment for recurrent or metastatic cervical cancer? ![]() A second rationale for using immunotherapy in cervical cancer is that most of these cancers express programmed death ligand 1 (PD-L1), which is an optimal target for immune checkpoint inhibition. LR Cervical cancer is a good target for immunotherapy because its presence indicates an impairment in the immune system most cases of cervical cancer occur in response to a failure of the immune system to clear the human papillomavirus (HPV). H&O What makes cervical cancer a good target for immunotherapy?
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |