The Comparative Effectiveness of Enlonstobart and Camrelizumab as Second-Line Recurrent or Metastatic Cervical Cancer...

Recurrent or metastatic cervical cancer (R/M CC) has limited therapeutic options after first-line treatment failure. Both enlonstobart and camrelizumab are anti-PD-1 antibodies recommended for second-line treatment, but direct comparative evidence is lacking. This study aimed to evaluate the relative efficacy of enlonstobart versus camrelizumab as second-line treatments in patients with R/M CC.

We conducted an unanchored matched-adjusted indirect comparison (MAIC) using individual patient data from the single-arm enlonstobart Phase II trial and published aggregate data from the camrelizumab phase II trial, both of which targeted an R/M CC population with prior platinum-based treatment failure. Entropy balancing was used to adjust for eight baseline covariates. Primary endpoints were overall survival (OS) and progression-free survival (PFS). Cox proportional hazards models were used to estimate hazard ratios (HRs) for the survival endpoints. A simulated treatment comparison (STC) was performed as sensitivity analysis.

Before adjustment, no significant differences were observed between treatments for OS or PFS. After MAIC adjustment, enlonstobart demonstrated significant OS advantage over camrelizumab (HR=0.51, 95% CI 0.27-0.94, p=0.03), with median OS of 32.2 versus 14.94 months. PFS showed a favorable trend but was not statistically significant (HR=0.69, 95% CI 0.42-1.14, p=0.15). STC analysis corroborated the OS benefit and suggested significant PFS advantage of enlonstobart over camrelizumab. Safety profiles were comparable between treatments.

This indirect comparison demonstrated that enlonstobart provided a significant OS advantage compared to camrelizumab in patients with second-line R/M CC. These findings suggest enlonstobart may represent a promising therapeutic option for PD-(L)1 positive R/M CC patients.