An early combination of concurrent chemoradiotherapy with immune checkpoint inhibitors for cervical cancer is superior to a late combination: a propensity-score matching analysis
PurposeThis study compared the timing effects of immune checkpoint inhibitor (ICIs) administration on the efficacy and safety of concurrent chemoradiotherapy for cervical cancer.MethodsThis study included patients with advanced cervical cancer who received concurrent chemoradiotherapy with ICIs. The...
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Frontiers Media S.A.
2024-11-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2024.1429176/full |
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| author | Yi-Ming Ma Shu-Xia Cheng Ming-Chuan Zhang Hui-Ying Zhang Jun-Jiao Gu Pan-Pan Zhao Hong Ge |
| author_facet | Yi-Ming Ma Shu-Xia Cheng Ming-Chuan Zhang Hui-Ying Zhang Jun-Jiao Gu Pan-Pan Zhao Hong Ge |
| author_sort | Yi-Ming Ma |
| collection | DOAJ |
| description | PurposeThis study compared the timing effects of immune checkpoint inhibitor (ICIs) administration on the efficacy and safety of concurrent chemoradiotherapy for cervical cancer.MethodsThis study included patients with advanced cervical cancer who received concurrent chemoradiotherapy with ICIs. The patients were divided into early-application (n=51) and late-application groups (n=56) according to the ICI application timing. The primary objective was assessing progression-free survival (PFS) and its associated factors; secondary objectives included assessing objective remission rates (ORR) and treatment-related adverse events (TRAEs).ResultsBefore propensity score matching (PSM), the median PFS (mPFS) times were significantly different: 11.5 months (95% CI: 11.0–13.2) and 7.5 months (95% CI: 6.5–9.0) for the early and late groups, respectively (P<0.001). After PSM, the mPFS times remained significantly different: 11.5 months (95% CI: 11.0–13.8) and 6.5 months (95% CI: 6.1–9.0), respectively (P<0.001). The PSM tumor-response ORR in the early combination group (74.3%) was significantly greater than the 31.4% in the late combination group (P<0.001). After PSM, multivariate Cox analysis showed tumor diameter (P=0.004), distant organ metastasis (P=0.047), and timing of combination therapy (P<0.001) were independently associated factors affecting PFS. The most common TRAEs in the two groups of patients were neutropenia, nausea and vomiting, and fatigue, with no significant difference in incidence (P>0.050).All adverse reactions were resolved, and no adverse reaction-related deaths occurred.ConclusionIn patients with cervical cancer treated with concurrent chemoradiotherapy, earlier immunotherapy improves survival and is equivalent in safety to ICIs late application. |
| format | Article |
| id | doaj-art-9c02e653dcee4dda9904616d816432b9 |
| institution | Kabale University |
| issn | 2234-943X |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj-art-9c02e653dcee4dda9904616d816432b92024-11-21T05:10:09ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2024-11-011410.3389/fonc.2024.14291761429176An early combination of concurrent chemoradiotherapy with immune checkpoint inhibitors for cervical cancer is superior to a late combination: a propensity-score matching analysisYi-Ming Ma0Shu-Xia Cheng1Ming-Chuan Zhang2Hui-Ying Zhang3Jun-Jiao Gu4Pan-Pan Zhao5Hong Ge6Department of Gynecologic Oncology, The Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, ChinaDepartment of Gynecologic Oncology, The Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, ChinaDepartment of Gynecologic Oncology, The Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, ChinaDepartment of Oncology, First Affiliated Hospital of Henan University, Kaifeng, ChinaDepartment of Oncology, Huaihe Hospital of Henan University, Kaifeng, ChinaDepartment of Gynecologic, First Affiliated Hospital of Henan University of Science and Technology, Jiaozuo, ChinaDepartment of Radiation Oncology, The Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, ChinaPurposeThis study compared the timing effects of immune checkpoint inhibitor (ICIs) administration on the efficacy and safety of concurrent chemoradiotherapy for cervical cancer.MethodsThis study included patients with advanced cervical cancer who received concurrent chemoradiotherapy with ICIs. The patients were divided into early-application (n=51) and late-application groups (n=56) according to the ICI application timing. The primary objective was assessing progression-free survival (PFS) and its associated factors; secondary objectives included assessing objective remission rates (ORR) and treatment-related adverse events (TRAEs).ResultsBefore propensity score matching (PSM), the median PFS (mPFS) times were significantly different: 11.5 months (95% CI: 11.0–13.2) and 7.5 months (95% CI: 6.5–9.0) for the early and late groups, respectively (P<0.001). After PSM, the mPFS times remained significantly different: 11.5 months (95% CI: 11.0–13.8) and 6.5 months (95% CI: 6.1–9.0), respectively (P<0.001). The PSM tumor-response ORR in the early combination group (74.3%) was significantly greater than the 31.4% in the late combination group (P<0.001). After PSM, multivariate Cox analysis showed tumor diameter (P=0.004), distant organ metastasis (P=0.047), and timing of combination therapy (P<0.001) were independently associated factors affecting PFS. The most common TRAEs in the two groups of patients were neutropenia, nausea and vomiting, and fatigue, with no significant difference in incidence (P>0.050).All adverse reactions were resolved, and no adverse reaction-related deaths occurred.ConclusionIn patients with cervical cancer treated with concurrent chemoradiotherapy, earlier immunotherapy improves survival and is equivalent in safety to ICIs late application.https://www.frontiersin.org/articles/10.3389/fonc.2024.1429176/fullimmune checkpoint inhibitorscervical cancerapplication timingprogression-free survivalobjective response ratetreatment-related adverse events |
| spellingShingle | Yi-Ming Ma Shu-Xia Cheng Ming-Chuan Zhang Hui-Ying Zhang Jun-Jiao Gu Pan-Pan Zhao Hong Ge An early combination of concurrent chemoradiotherapy with immune checkpoint inhibitors for cervical cancer is superior to a late combination: a propensity-score matching analysis Frontiers in Oncology immune checkpoint inhibitors cervical cancer application timing progression-free survival objective response rate treatment-related adverse events |
| title | An early combination of concurrent chemoradiotherapy with immune checkpoint inhibitors for cervical cancer is superior to a late combination: a propensity-score matching analysis |
| title_full | An early combination of concurrent chemoradiotherapy with immune checkpoint inhibitors for cervical cancer is superior to a late combination: a propensity-score matching analysis |
| title_fullStr | An early combination of concurrent chemoradiotherapy with immune checkpoint inhibitors for cervical cancer is superior to a late combination: a propensity-score matching analysis |
| title_full_unstemmed | An early combination of concurrent chemoradiotherapy with immune checkpoint inhibitors for cervical cancer is superior to a late combination: a propensity-score matching analysis |
| title_short | An early combination of concurrent chemoradiotherapy with immune checkpoint inhibitors for cervical cancer is superior to a late combination: a propensity-score matching analysis |
| title_sort | early combination of concurrent chemoradiotherapy with immune checkpoint inhibitors for cervical cancer is superior to a late combination a propensity score matching analysis |
| topic | immune checkpoint inhibitors cervical cancer application timing progression-free survival objective response rate treatment-related adverse events |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2024.1429176/full |
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