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ORIGINAL RESEARCH article

Front. Oncol.
Sec. Gynecological Oncology
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1429176

An early combination of concurrent chemoradiotherapy with immune checkpoint inhibitors for cervical cancer is superior to a late combination: A propensity-score matching analysis

Provisionally accepted
Yi-Ming Ma Yi-Ming Ma 1Hong Ge Hong Ge 1*Shu-Xia Cheng Shu-Xia Cheng 1Ming-Chuan Zhang Ming-Chuan Zhang 1Hui-Ying Zhang Hui-Ying Zhang 2Jun-Jiao Gu Jun-Jiao Gu 3Pan-Pan Zhao Pan-Pan Zhao 4
  • 1 Henan Provincial Cancer Hospital, Zhengzhou, China
  • 2 First Affiliated Hospital of Henan University, Kaifeng, Henan Province, China
  • 3 Huaihe Hospital, Henan University, Kaifeng, Henan Province, China
  • 4 The First Affiliated Hospital of Henan University of Science and Technology, Luoyang, Henan Province, China

The final, formatted version of the article will be published soon.

    Purpose: This study compared the timing effects of immune checkpoint inhibitor (ICIs) administration on the efficacy and safety of concurrent chemoradiotherapy for cervical cancer. Methods: This study included patients with advanced cervical cancer who received concurrent chemoradiotherapy with ICIs. The patients were divided into early-application (n=51) and late-application groups (n=56) according to the ICI application timing. The primary objective was assessing progression-free survival (PFS) and its associated factors; secondary objectives included assessing objective remission rates (ORR) and treatment-related adverse events (TRAEs). Results: Before propensity score matching (PSM), the median PFS (mPFS) times were significantly different: 11.5 months (95% CI: 11.0-13.2) and 7.5 months (95% CI: 6.5-9.0) for the early and late groups, respectively (P<0.001). After PSM, the mPFS times remained significantly different: 11.5 months (95% CI: 11.0-13.8) and 6.5 months (95% CI: 6.1-9.0), respectively (P<0.001). The PSM tumour-response ORR in the early combination group (74.3%) was significantly greater than the 31.4% in the late combination group (P<0.001). After PSM, multivariate Cox analysis showed tumour diameter (P=0.004), distant organ metastasis (P=0.047), and timing of combination therapy (P<0.001) were independently associated factors affecting PFS. The most common TRAEs in the two groups of patients were neutropenia, nausea and vomiting, and fatigue, with no significant difference in incidence (P>0.050).All adverse reactions were resolved, and no adverse reaction-related deaths occurred.In patients with cervical cancer treated with concurrent chemoradiotherapy, earlier immunotherapy improves survival and is equivalent in safety to ICIs late application.

    Keywords: immune checkpoint inhibitors, cervical cancer, Application timing, Progression-free survival, Objective response rate, Treatment-related adverse events

    Received: 07 May 2024; Accepted: 04 Nov 2024.

    Copyright: © 2024 Ma, Ge, Cheng, Zhang, Zhang, Gu and Zhao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Hong Ge, Henan Provincial Cancer Hospital, Zhengzhou, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.