The efficacy and safety of neoadjuvant chemotherapy plus immune check point inhibitors for locally advanced cervical cancer: a systematic review and meta-analysis.
4 affiliations
- 1Department of Gynecology, Haidian District Maternal and Child Health Care Hospital, Beijing, China.
- 2Department of Gynecology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China.
- 3Department of Gynecology, Haidian District Maternal and Child Health Care Hospital, Beijing, China. [email protected].
- 4Department of Gynecologic Oncology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital. Laboratory for Clinical Medicine, Capital Medical University, Beijing, China. [email protected].
Abstract
Objective
Immune checkpoint inhibitors (ICIs) enable organ preservation strategies and surgical de-escalation in multiple cancers.In locally advanced cervical cancer (LACC), neoadjuvant chemotherapy plus immune checkpoint inhibitors (NACI) may improve tumor response.This study conducted a systematic review and meta-analysis to evaluate the response rates and safety of NACI in LACC.Methods
We systematically searched PubMed, Web of Science, Cochrane Library, and Embase from inception to March 2025, including major congress abstracts. Phase II/III trials or retrospective analyses reporting pathological complete response (pCR), objective response rate (ORR), and adverse events (AEs) for NACI in LACC were included. Two investigators independently extracted data. Pooled rates were calculated using STATA 18.0 with random-effects models (I² statistic assessed heterogeneity).Results
Three clinical studies involving 162 patients with locally advanced cervical cancer were included in the meta-analysis. The pooled ORR was 95.5% (95% confidence interval [CI],90.8-98.6%), while the pooled pCR rate was 45.5% (95% CI, 27.7-63.2%). Grade 3 or higher AEs occurred at a pooled rate of 35.5% (95% CI, 28.2-42.9%). Sensitivity analysis confirmed the reliability of the meta-analytic findings.Conclusion
The combination of chemotherapy and PD-1/PD-L1 inhibitors achieved 45.5% pCR and tolerable toxicity .The results provide theoretical basis for further studies in reducing the scope of surgery under specific conditions to minimize complicationsr surgery or preserving fertility.Synopsis
Neoadjuvant PD-1/PD-L1 inhibitors with chemotherapy achieved 95.5% ORR and 45.5% pCR in LACC (3 studies, n=162). Grade ≥3 AEs occurred in 35.5% of patients.
Related
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- Evaluation of the efficacy and safety of different cycles of neoadjuvant chemotherapy combined with immunotherapy in locally advanced esophageal squamous cell carcinoma: a multi-center, real-world study.
- Efficacy and safety of PD-1/PD-L1 inhibitors plus chemotherapy ± bevacizumab for recurrent or metastatic cervical cancer: a systematic review and meta-analysis of randomized controlled trials
- Neoadjuvant chemotherapy in locally advanced colon cancer: lessons from the NeoCol trial and the limits of anatomical risk stratification.
- Relative change rate of neutrophil-to-albumin ratio (ΔNAR) during neoadjuvant chemotherapy predicts axillary pathological complete response in locally advanced breast cancer
BibTeX
@article{xu2026efficacy,
title = {{The efficacy and safety of neoadjuvant chemotherapy plus immune check point inhibitors for locally advanced cervical cancer: a systematic review and meta-analysis.}},
author = {Jianqing Xu and Jing Chen and Lin Zhu and Ming Wang},
journal = {BMC cancer},
year = {2026},
month = jul,
doi = {10.1186/s12885-026-16585-z},
url = {https://europepmc.org/article/MED/42894145},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - The efficacy and safety of neoadjuvant chemotherapy plus immune check point inhibitors for locally advanced cervical cancer: a systematic review and meta-analysis.
AU - Jianqing Xu
AU - Jing Chen
AU - Lin Zhu
AU - Ming Wang
PY - 2026
DA - 2026/07/01
JO - BMC cancer
DO - 10.1186/s12885-026-16585-z
UR - https://europepmc.org/article/MED/42894145
AB - Objective Immune checkpoint inhibitors (ICIs) enable organ preservation strategies and surgical de-escalation in multiple cancers.In locally advanced cervical cancer (LACC), neoadjuvant chemotherapy plus immune checkpoint inhibitors (NACI) may improve tumor response.This study conducted a systematic review and meta-analysis to evaluate the response rates and safety of NACI in LACC.Methods We systematically searched PubMed, Web of Science, Cochrane Library, and Embase from inception to March 2025, including major congress abstracts. Phase II/III trials or retrospective analyses reporting pathological complete response (pCR), objective response rate (ORR), and adverse events (AEs) for NACI in LACC were included. Two investigators independently extracted data. Pooled rates were calculated using STATA 18.0 with random-effects models (I² statistic assessed heterogeneity).Results Three clinical studies involving 162 patients with locally advanced cervical cancer were included in the meta-analysis. The pooled ORR was 95.5% (95% confidence interval [CI],90.8-98.6%), while the pooled pCR rate was 45.5% (95% CI, 27.7-63.2%). Grade 3 or higher AEs occurred at a pooled rate of 35.5% (95% CI, 28.2-42.9%). Sensitivity analysis confirmed the reliability of the meta-analytic findings.Conclusion The combination of chemotherapy and PD-1/PD-L1 inhibitors achieved 45.5% pCR and tolerable toxicity .The results provide theoretical basis for further studies in reducing the scope of surgery under specific conditions to minimize complicationsr surgery or preserving fertility.Synopsis Neoadjuvant PD-1/PD-L1 inhibitors with chemotherapy achieved 95.5% ORR and 45.5% pCR in LACC (3 studies, n=162). Grade ≥3 AEs occurred in 35.5% of patients.
SN - 1471-2407
ER -