Low-Dose Metronomic Chemotherapy With Fixed Low-Dose Nivolumab for Recurrent Cervical Cancer After Radiotherapy:...

Area of Science:

• Oncology
• Immunotherapy
• Cancer Treatment

Background:

• Recurrent cervical cancer post-radiotherapy is challenging, especially in low-resource settings.
• Standard immune checkpoint inhibitors are costly and have long treatment durations, limiting access.
• Affordable strategies with retained biological activity are crucial for managing recurrent cervical cancer.

Purpose of the Study:

• To evaluate the efficacy and safety of low-dose nivolumab combined with metronomic chemotherapy in patients with recurrent cervical cancer.
• To explore an accessible treatment option for recurrent cervical cancer in resource-limited environments.

Main Methods:

• Retrospective review of 21 patients with recurrent cervical cancer post-radiotherapy/chemoradiotherapy.
• Treatment involved fixed low-dose nivolumab (20 mg every two weeks) plus metronomic oral methotrexate or capecitabine.
• Clinical outcomes assessed included progression-free survival, overall survival, response rates, and toxicity.

Main Results:

• Overall response rate was 38% (8/21 patients); disease control was achieved in 67% (14/21 patients).
• Median progression-free survival was 8.6 months; median overall survival was 15 months.
• One-year and two-year overall survival rates were 61% and 42%, respectively. Treatment was well-tolerated with mostly grade 1/2 adverse events.

Conclusions:

• Low-dose nivolumab with metronomic chemotherapy is a feasible and pragmatic option for selected recurrent cervical cancer patients.
• This combination shows promise, particularly in settings with limited access to standard immunotherapy.
• Further prospective studies are warranted to validate these findings.