Medical Interview | Professor Zhang Yunyan: Inventory of the latest research progress of cervical cancer immunotherapy at major international annual meetings

In the world, due to the application of HPV vaccines, the incidence of cervical cancer decreases by about 1%to 1.9%per year. In our country, cervical cancer is the most common gynecological malignant tumor. The incidence is still rising year by year. In 2022, the latest national cancer reports. The number of new cervical cancers is 109,700, and the number of annual deaths is 59,100, which seriously endangers women's health. In particular, patients with advanced and recurrence of metastatic cervical cancer were poor, and the 5 -year survival rate was only 17%.

In recent years, immunotherapy, as a new treatment model, has made exciting progress in a variety of malignant tumors. It has also brought new hope to patients with recurrence and metastatic cervical cancer. pattern. In 2022, the latest research of many cervical cancer immunotherapy was announced at the International Oncology Conference such as SGO and ASCO. "Medical Daily" invited Professor Zhang Yunyan Zhang Yunyan, an affiliated to Harbin Medical University.

01

Immunotherapy

In recent years, immunotherapy has made breakthroughs in the treatment of cervical cancer patients. In 2022, the ASCO Annual Meeting announced the results of the analysis of the KEYNOTE826 research on multiple Asian groups. The study showed that Paborzab's anti -anti -anti -anti -anti -anti -anti -anti -anti -anti -anti -anti -antichard (paclitaxel + cisplatin/card platinum) ± Bevar bead single anti -single anti -recurring or metastatic cervical cancer cancer First -line treatment, compared to chemotherapy ± Bevarzab can significantly improve patients with no progressive survival (PFS: 10.4 VS 8.2 months) and overall survival period (OS: 24.4 VS 16.5 months), and intentional treatment (ITT) Patients with the crowd of ORR reached 65.9%, and patients with PD-L1/CPS ≥ 1, PD-L1/CPS ≥ 10 were improved. The results of the key patients with extensive selection further support the new standard treatment schemes of Paborzab's combination of Paborzab + chemotherapy combined with or not combined with Bedarzab as sustainable, recurrence or metastatic cervical cancer. The plan has been approved by the FDA and included in the first -line treatment recommendation of the new version of NCCN cervical cancer guidelines in 2022.

HLX10-011-CC201, led by Professor Wu Lingying of the Academy of Medical Sciences, was selected as an oral report of the SGO conference in 2022. This domestic multi-centered and single-arm phase II study, 21 cases of first-line chemotherapy progress or inadequate treatment of first-line treatment and PD-L1 positive (CPS ≥ 1) patients with advanced cervical cancer were given Black protein paclitaxel combined treatment. Data with a median follow -up time of 14.6 months showed that ORR reached 57.1%; DCR was 76.2%; the median Dor has not yet reached, and the median PFS and OS are 5.7 months and 15.5 months, respectively. Safety performance is good. HLX10-011-CC201 is the first study based on the Chinese population and Chinese solution to discuss immunochemical combined chemotherapy for cervical cancer second-line therapy. The study confirms the efficacy and safety of Srusley monoclonal antibodies + white protein organs.

02

Immunomorphic combined radiotherapy

The combination of radiotherapy and immunotherapy is gradually considered a combination of anti -tumor treatment with potential application value. Freckage can induce tumor cell death, activate immune cells, and promote the phagocytic effect of tumor cells. Immune cells activate CD8+T cells, PD-1/PD-L1 blocking immune originality that can eliminate chemotherapy. PD-1/PD-L1 monoclonal anti-anti-resistance and synchronous mortar chemotherapy combined with the start of DNA fracture, cell death, phagocytosis and antigen presented to induce enhanced immunogenic environment, re-activate immune-mediated tumor monitoring, and enhance anti-tumor activity. Give play to synergy.

At the SGO conference in 2022, Jyoti Mayadev reported a phase I NRG-GY017 Study, which will be transferred with IB to IVA with aorta mortar or IIB ～ ⅳA pelvic lymph nodes. 40 patients with metastasis were randomly divided into two groups: Group A: receiving 1 dose of Anti -Zhuabi before distributing chemotherapy, and then receiving two doses of Aidari Mipide (n = 19) during the distribution of chemotherapy (n = 19); Group B; : Simultaneously accepting 3 doses of Antizumab (n = 17) during chemotherapy. The test results show that Ayidarzumab can be combined with immunotherapy or large -scale chemotherapy to treat local advanced lymph node positive cervical cancer. Simultaneous use of Ayidzumab or starting the combined chemotherapy of Aidarzumab has good safety and tolerance. Although T -cell cloning amidity observed in tumors and peripheral blood has nothing to do with sequencing, this method can be associated with PFS and OS. The PFS results of this experiment are good, the dose restrictions are low (DLT), and the evidence of cloning T cell amplification in tumors and peripheral blood, which provides a bright prospect for PD-L1 in future use.

03

Other immunohistochemical treatment

Professor Wu Lingying reported a study at the SGO conference in 2022. The study uses TIGIT monoclonal Ociperlimab (Ociperlimab), which is a suppressing receptor expressed on immune cells. This international multi-center research proposed 167 patients with advanced cervical cancer patients who progressed after chemotherapy after chemotherapy. Test; PD-L1 in the second phase of patients is forward-looking test); queue 2 patients: gives single medicine for Relyrzumab. The main end of the study is the ORR of Queen 1 (including PD-L1 TPS ≥ 5%and regardless of PD-L1). In 2022, the ASCO conference reported on the mid -term results of the phase INOVATV 205 studying the treatment of recurrence or metastatic cervical cancer. At this conference, the results of the second -line/third -line TV + Paborzab and the first line of tv + karplatin were disclosed. The new antibody puppet drug (ADC) TISOTUMAB VEDOTIN (TV) combined with Pabberzetsu monocrical or card platinum therapy R/MCC dosage expansion queue shows strong and long -lasting anti -tumor activity and tolerable safety in the dose queue. The objective relief rate (ORR) of the TV + Paborizhu Single Resistance Group is 40.6%(13/32, 5 CR, 8 cases of PR), and the disease control rate (DCR) is 84.4%; Both the continuous relief time (DOR) and OS have not been reached; the incidence of adverse events (TEAE) during the treatment period of ≥ 3 is 67%. (9%). Among patients with relapse metastatic cervical cancer, the dose extension queue of TV combined with Pemvro or Carbo shows encouraging and lasting anti -tumor activity, safety and tolerance.

04

Professor Zhang Yunyan summarizes

Patients with advanced and recurring metastatic cervical cancer are not good, and have always been a difficult challenge facing clinicians. A number of studies such as immune combined chemotherapy, immune combined anti -vascular treatment, and dual -free treatment are actively developing. It has made breakthrough progress in treatment and has good safety and feasibility. At present, the task of medical research is to do more transformation in the immune micro -environment, and focus on predicting and prognosis -specific biomarkers to solve problems such as low relief rate and more clinical adverse reactions. Formulate a more complete treatment strategy for immunotherapy and chemotherapy to benefit patients with advanced cervical cancer.

Expert Introduction

Professor Zhang Yunyan

Harbin Medical University Affiliated Oncology Hospital

President of Gynecological Treatment Ward Professor Second -level Professor Ph.D. Tutor

Longjiang famous doctor

Standing Member of the China Anti -Cancer Association's close -range radiation therapy professional committee

Member of the close -range therapy group of the Chinese Medical Association Radi and therapy Specialty Committee

Member of the Gynecological Oncology Radiotherapy Group of the Chinese Medical Doctors Association

CSCO Gynecological Cancer Professional Committee

Member of the Women's Tumoring Group of Precision Medicine and Tumor MDT Society of Chinese Research Hospital

Executive Director of Heilongjiang Anti -Cancer Association

Chairman of the Heilongjiang Medical Association Gynecological Tumor Radiation Treatment Professional Committee

Deputy Chairman of Heilongjiang Medical Association Gynecological Oncology Sub -Association

Executive Member of the Obstetrics and Gynecology Committee of Heilongjiang Provincial Medical Association

Executive Member of the Anti -Cancer Association Anti -Cancer Association of Heilongjiang Province

Member of Heilongjiang Medical Association Obstetrics and Gynecology Branch

Member of the Heilongjiang Medical Association Tumor Radiation Treatment Professional Committee

He studied at the University of Pittsburgh and MD Anderson oncology Center. Presided one key project of the National Natural Regional United Fund and 2 projects on the National Nature. Provincial natural key project. 1 provincial key R & D project. Won one second prize of the provincial government scientific and technological progress, and 1 first prize of the Provincial Department of Health. The Provincial Department of Health has three prizes for new medical technology. Published more than 20 SCI papers. Participate in 5 planning materials for the Ministry of Health.

Good at radiotherapy and comprehensive treatment of gynecological tumors such as cervical cancer, endometrial cancer. The province took the lead in carrying out three -dimensional installation and insertion treatment. Master the most advanced in vitro radiotherapy technology including Tomo and VMAT. It has rich clinical experience for comprehensive treatment (immunotherapy and targeted therapy) of gynecological tumors such as advanced and recurrence of cervical cancer.

Capture: Hu Haiyan

Edit: Wang Lina

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