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Table of Contents
LETTER TO THE EDITOR
Year : 2021  |  Volume : 4  |  Issue : 4  |  Page : 808-809

Pembrolizumab in recurrent or metastatic cervical cancer


Department of Medical Oncology, Dr. B.R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India

Date of Submission12-Dec-2021
Date of Decision13-Dec-2021
Date of Acceptance13-Dec-2021
Date of Web Publication29-Dec-2021

Correspondence Address:
Ajay Gogia
Department of Medical Oncology, Dr. B.R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi - 110 029
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/crst.crst_316_21

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How to cite this article:
Ganguly S, Gogia A. Pembrolizumab in recurrent or metastatic cervical cancer. Cancer Res Stat Treat 2021;4:808-9

How to cite this URL:
Ganguly S, Gogia A. Pembrolizumab in recurrent or metastatic cervical cancer. Cancer Res Stat Treat [serial online] 2021 [cited 2022 Jan 21];4:808-9. Available from: https://www.crstonline.com/text.asp?2021/4/4/808/334236



Colombo et al.[1] recently reported improved survival outcomes with the addition of pembrolizumab to standard chemotherapy with or without bevacizumab in recurrent/metastatic cervical cancer. A total of 389 of 617 (63%) study participants received concomitant bevacizumab. We noted with interest that the use of concomitant bevacizumab was associated with an improved outcome with pembrolizumab. Tumor vasculature is increasingly being recognized for attenuating cancer immunity, and the use of combined angiogenic blockade and immune checkpoint inhibitors has the potential for synergism.[2] This synergy may be further explored in biomarker analysis of the trial participants.

We also observed that patients with metastatic disease at diagnosis (122/617; 19.8% of patients) did not derive any benefit from the addition of pembrolizumab, across all subgroups of programmed death ligand 1 expression. Prior exposure to cytotoxic therapy has the potential to enhance the response to subsequent treatment with checkpoint inhibitors, via induction of cell death and effects on the tumor microenvironment.[3] Hence, patients who have received prior radiation/chemoradiation might have better outcomes with the addition of pembrolizumab to chemotherapy. Therefore, further subgroup analysis of outcomes and responses, based on prior therapy exposure, may be considered.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Colombo N, Dubot C, Lorusso D, Caceres MV, Hasegawa K, Shapira-Frommer R, et al. Pembrolizumab for persistent, recurrent, or metastatic cervical cancer. N Engl J Med 2021;385:1856-67.  Back to cited text no. 1
    
2.
Lee WS, Yang H, Chon HJ, Kim C. Combination of anti-angiogenic therapy and immune checkpoint blockade normalizes vascular-immune crosstalk to potentiate cancer immunity. Exp Mol Med 2020;52:1475-85.  Back to cited text no. 2
    
3.
Opzoomer JW, Sosnowska D, Anstee JE, Spicer JF, Arnold JN. Cytotoxic chemotherapy as an immune stimulus: A molecular perspective on turning up the immunological heat on cancer. Front Immunol 2019;10:1654.  Back to cited text no. 3
    




 

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