The current status of immunotherapy for cervical cancer

Rep Pract Oncol Radiother. 2018 Nov-Dec;23(6):580-588. doi: 10.1016/j.rpor.2018.05.001. Epub 2018 May 18.


Immunotherapy has been proven effective in several tumours, hence diverse immune checkpoint inhibitors are currently licensed for the treatment of melanoma, kidney cancer, lung cancer and most recently, tumours with microsatellite instability. There is much enthusiasm for investigating this approach in gynaecological cancers and the possibility that immunotherapy might become part of the therapeutic landscape for gynaecological malignancies. Cervical cancer is the fourth most frequent cancer in women worldwide and represents 7.9% of all female cancers with a higher burden of the disease and mortality in low- and middle-income countries. Cervical cancer is largely a preventable disease, since the introduction of screening tests, the recognition of the human papillomavirus (HPV) as an etiological agent, and the subsequent development of primary prophylaxis against high risk HPV subtypes. Treatment for relapsed/advanced disease has improved over the last 5 years, since the introduction of antiangiogenic therapy. However, despite advances, the median overall survival for advanced cervical cancer is 16.8 months and the 5-year overall survival for all stages is 68%. There is a need to improve outcomes and immunotherapy could offer this possibility. Clinical trials aim to understand the best timing for immunotherapy, either in the adjuvant setting or recurrent disease and whether immunotherapy, alone or in combination with other agents, improves outcomes.

Keywords: APC, antigen-presenting cell; Adoptive T cell therapy; CAR, chimeric antigen receptor; CD4, -8, -80, cluster of differentiation 4, -8, -80; CTL, cytotoxic-T lymphocyte; CTLA-4, cytotoxic T-lymphocyte-associated protein 4; Cervical cancer; DC, dendritic cell; DFS, disease free survival; DNA, deoxyribonucleic acid; FIGO, International Federation of Gynecology and Obstetrics; HLA, human leucocyte antigen; HPV, human papilloma virus; Human papillomavirus; IL-2, interleukin 2; ILT's, Ig-like transcripts; Immune checkpoints inhibitors; LLO, listerolysin O; Lm, Listeria monocytogenes; MAGE-A3, melanoma-associated antigen 3; MCH, major histocompatibility complex; ORR, objective response rate; OS, overall survival; PD-1, programmed cell death protein 1; PD-L1, programmed death-ligand 1; PFS, progression free survival; RNA, ribonucleic acid; SLP, synthetic long-peptide; TCR, T-cell receptor; TGFβ, transforming growth factor beta; TILs, tumor-infiltrating lymphocytes; TRAEs, treatment related adverse events; Therapeutic vaccines.

Publication types

  • Review