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Intramucosal Inoculation of Squamous Cell Carcinoma Cells in Mice for Tumor Immune Profiling and Treatment Response Assessment
Published on: April 22, 2019
Comparative effectiveness of immune checkpoint inhibitors in squamous vs. non-squamous cervical carcinoma: a
Li-Fang Lan1, Yu-Jie Chen1, Dun-Chang Mo2
1Department of Gynecology, Liuzhou People's Hospital Affiliated to Guangxi Medical University, Liuzhou, China.
Background:
The differential therapeutic efficacy of immune checkpoint inhibitor (ICI) therapy in patients with cervical squamous cell carcinoma (SCC) and non-squamous cell carcinoma (non-SCC) remains unclear. This study aimed to evaluate and compare the efficacy of ICI therapy in patients with metastatic cervical SCC and non-SCC.
Methods:
A systematic literature search was conducted in PubMed, Embase, and the Cochrane Library to identify randomized controlled trials (RCTs) investigating the efficacy of ICI therapy for metastatic cervical cancer. The primary efficacy endpoints were overall survival (OS), progression-free survival (PFS), and objective response rate (ORR).
Results:
Four eligible RCTs were included in this meta-analysis. ICI therapy significantly improved PFS and OS in both SCC and non-SCC patients compared with the control treatment. Anti-programmed cell death protein 1 (anti-PD-1) monotherapy significantly increased the ORR in SCC patients (P<0.001), while no significant improvement was observed in non-SCC patients (P=0.23). Subgroup analysis showed that anti-PD-1 and anti-PD-1/CTLA-4 combination therapies significantly prolonged PFS in SCC patients (both P<0.001), but not in non-SCC patients (P=0.13 and P=0.83, respectively). In contrast, anti-programmed cell death ligand 1 (anti-PD-L1) therapy failed to improve PFS in SCC patients (P=0.22) but significantly enhanced PFS in non-SCC patients (P<0.001). OS subgroup analysis revealed that anti-PD-1, anti-PD-L1, and anti-PD-1/CTLA-4 therapies all significantly prolonged OS in SCC patients. In non-SCC patients, only the anti-PD-1 subgroup exhibited a significant OS benefit (P=0.006), with no statistically significant differences observed in the anti-PD-L1 and anti-PD-1/CTLA-4 subgroups (P=0.08 and P=0.83, respectively).
Conclusions:
ICI therapy improves clinical outcomes in patients with metastatic cervical cancer, but its efficacy varies significantly between SCC and non-SCC subtypes. These findings warrant high attention in clinical practice and provide a reference for individualized therapeutic decision-making.
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