Immunotherapeutic options for management of metastatic cervical cancer

Cervical cancer (CC) remains one of the common tumour diseases of women. It accounts for 9.8% of all neoplasia in women. The Food and Drug Administration approved pembrolizumab with PD-1 inhibitor antibodies for the treatment of RSM following the KEYNOTE-158 clinical trial. PD-L1/PD-1 inhibitors have shown promising results against objective response rate in female patients with CC. A clinical case of pembrolizumab treatment of a patient with metastatic CC with progression after radiotherapy and pelvic organ evisceration is described. The patient underwent IHC examination of the tumour material and was found to have PDL1 expression of more than 1% according to the 22C3 antibody assay. According to the instructions for Pembroria® it was decided to start systemic chemotherapy in the regimen of paclitaxel 175 mg/m², carboplatin AUC5 and pembrolizumab at a dose of 200 mg every three weeks. After the third course, a control MRI study was performed. A partial response according to iRECIST criteria was confirmed. After the sixth course of therapy cytostatics were cancelled, the patient continued monotherapy with pembrolizumab 200 mg once every three weeks. At the control MRI after 10 months of therapy, the tumour conglomerate in the right hindbrain fossa was not detected and a complete response was confirmed. In the given observation anti-PD1 therapy and metastatic CC allowed to achieve complete remission of the disease. Thus, the clinical observation demonstrates the efficacy of pembrolizumab therapy in patients with advanced CC.

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