According to a story from Medpage Today, a recent study found that a dual immunotherapy approach could be an effective treatment for cervical cancer that had been previously treated, has spread, or has recurred. The two drugs being evaluated as part of the trial were zalifrelimab (an anticytotoxic T-lymphocyte–associated antigen-4 antibody) and balstilimab, an anti-programmed death-1 (PD-1) antibody. This study was a phase II trial and included a total of 155 patients.
About Cervical Cancer
Cervical cancer is a cancer that affects the cervix, which is the lower part of the uterus. It often does not cause symptoms at first. In the majority of cases, infection with human papillomavirus (HPV) is the cause. Other risk factors include smoking, using oral contraceptives for a long time, and having a large number of children. The majority of cervical cancers are squamous cell carcinoma. Symptoms include vaginal bleeding, bleeding after sex, pain during sex, vaginal discharge, swollen legs, pain affecting the pelvis, legs, or back, fatigue, weight loss, and appetite loss. Treatment for cervical cancer can include hysterectomy, trachelectomy, radiation therapy, and chemotherapy, sometimes in combination. Outcomes for this cancer have improved in developed nations, mostly due to earlier detection via screening. The five year survival rate in the US is around 68 percent. To learn more about cervical cancer, click here.
David O’Malley, MD, director of the Division of Gynecologic Oncology at the Ohio State University/James Comprehensive Cancer Center, notes that this is the biggest trial so far to evaluate a dual checkpoint inhibitor approach for cervical cancer. The overall response rate was 25.6 percent but increased to 32.8 percent in patients that were PD-L1 positive. 8 percent of these patients had a complete response to the treatment.
This level of response on PD-L1 positive patients is over twice the rate seen using single therapy inhibition of PD-1 in the past. At one year, the duration of the treatment response was 64 percent. That’s also better than many other approaches. A 3-4 month response duration is more typical in recurrent cervical cancer. Overall, the response rate and duration was greater than other therapies.
Furthermore, the combination of balstilimab and zalifrelimab also performed better than balstilimab alone. Dr. O’Malley says this is because zalifrelimab is able to help rejuvenate exhausted T-cells, therefore allowing a greater response. Dual immunotherapy could play an important role in the future treatment of cervical cancer, but for now, this combination will continue to be evaluated in trials.