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PD-1 Inhibition With Camrelizumab in Cervical Cancer: A Systematic Review and Meta-Analysis
Adeena Musheer1, Muhammad S Mannan2, Muhammad W Khan3
1Department of Internal Medicine, Dow Medical College, DUHS, Karachi.
Objectives:
Cervical cancer is the fourth leading cause of cancer mortality in women worldwide. PD-L1 is expressed in 34.4% to 96% of cervical cancers. Camrelizumab is an anti-PD-1 IgG4 antibody with antitumor activity. This study evaluates the efficacy and safety of camrelizumab in cervical cancer.
Methods:
A systematic search of PubMed, Embase, Web of Science, Cochrane Library, Ovid MEDLINE, and Scopus was performed to identify studies of pathologically confirmed cervical cancer treated with camrelizumab alone or in combination with chemotherapy or VEGFR-TKIs, including apatinib or famitinib. Eligible studies included randomized trials, single-arm trials, cohort studies, and case-control studies. Pooled proportions with 95% CIs were calculated using R version 4.4.1. Heterogeneity was assessed using I2 , and evidence certainty was evaluated using GRADE.
Results:
Eight studies comprising 382 patients were included. Camrelizumab was evaluated as monotherapy, with chemotherapy, or with VEGFR-TKIs. The pooled objective response rate (ORR) was 0.62 (95% CI: 0.32-0.85). The disease control rate (DCR), assessed in 7 studies including 297 patients, was 0.83 (95% CI: 0.60-0.94). The pooled partial response (PR) rate was 0.45 (95% CI: 0.29-0.62), while the complete response (CR) rate was 0.15 (95% CI: 0.10-0.23). Progressive disease (PD) outcomes were reported in a cohort of 297 patients, corresponding to a proportion of 0.16 (95% CI: 0.06-0.36), and stable disease (SD) demonstrated a pooled proportion of 0.30 (95% CI: 0.19-0.44). Commonly reported adverse events included neutropenia, anemia, leukopenia, hypertension, lymphopenia, and myelosuppression.
Conclusions:
Camrelizumab demonstrates clinically meaningful antitumor activity in cervical cancer, particularly in combination regimens, though toxicity requires careful monitoring.
Insights
Camrelizumab shows significant antitumor effects in cervical cancer, especially when combined with other treatments. Careful monitoring of side effects like neutropenia and anemia is crucial for patient safety.
Area of Science:
- Oncology
- Immunotherapy
- Clinical Trials
Background:
- Cervical cancer is a major global health concern for women.
- Programmed death-ligand 1 (PD-L1) is frequently expressed in cervical tumors.
- Camrelizumab, an anti-programmed death-1 (PD-1) antibody, exhibits anti-cancer properties.
Purpose of the Study:
- To evaluate the efficacy and safety of camrelizumab in cervical cancer patients.
- To assess response rates and disease control with camrelizumab-based therapies.
- To identify common adverse events associated with camrelizumab treatment.
Main Methods:
- Systematic literature search across major databases (PubMed, Embase, Web of Science, etc.).
- Inclusion of randomized trials, single-arm trials, cohort, and case-control studies.
- Calculation of pooled proportions and heterogeneity assessment using R software.
Main Results:
- Eight studies with 382 patients were analyzed.
- Pooled objective response rate (ORR) was 62%; disease control rate (DCR) was 83%.
- Common adverse events included neutropenia, anemia, and hypertension.
Conclusions:
- Camrelizumab demonstrates clinically significant antitumor activity in cervical cancer.
- Combination regimens involving camrelizumab appear particularly effective.
- Management of treatment-related toxicities is essential for optimal outcomes.
