Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, Jiangsu, China
Yangzhou University, Yangzhou, Jiangsu, China.
J Immunother Cancer. 2024 Nov 27;12(11):e009898. doi: 10.1136/jitc-2024-009898.
Recurrent or metastatic cervical cancer (r/m CC) presents limited treatment options for patients failed or progressed quickly following first-line therapy. This study investigated the potential of sintilimab with a prophylactic human papillomavirus (HPV) quadrivalent vaccine as a second-line treatment for r/m CC.
In this phase 2 clinical trial, patients with r/m CC previously unresponsive or intolerant to standard treatments for metastatic or recurrent lesions were enrolled. Participants received sintilimab (3 mg/kg for body weight <60 kg; 200 mg for ≥60 kg) every 3 weeks until 24 months or 35 cycles and 3 doses of the HPV quadrivalent vaccine (initial dose prior to sintilimab initiation, with subsequent doses at 2 and 6 months). The primary endpoint was the objective response rate (ORR). A Simon two-stage optimal design was used.
From October 2019 to October 2022, 13 patients with r/m CC were enrolled. ORR achieved 53.8% (95% CI 25.1% to 80.8%), and the disease control rate was 76.9% (95% CI 46.2% to 95.0%). Median follow-up duration was 16.07 months (range: 3.64-48.2 months), and median progressive free survival was 7.16 months (95% CI 1.91 -not applicable (NA)). The median overall survival (OS) was not reached (95% CI 9.89 -NA). Hypothyroidism (15.6%) was the most common treatment-related adverse event (AE). No grade 3 or above AEs were observed.
This study suggests the combination of sintilimab plus prophylactic HPV vaccine offers a potentially promising therapeutic strategy for patients with r/m CC unresponsive or intolerant to standard therapies.Trial registration numberNCT04096911.
复发或转移性宫颈癌(r/m CC)患者在一线治疗失败或快速进展后,治疗选择有限。本研究旨在探讨信迪利单抗联合预防性 HPV 四价疫苗作为 r/m CC 二线治疗的潜力。
这是一项 2 期临床试验,招募了既往对转移性或复发性病变的标准治疗无反应或不耐受的 r/m CC 患者。参与者接受信迪利单抗(体重<60kg 者为 3mg/kg;≥60kg 者为 200mg)每 3 周一次,持续 24 个月或 35 个周期,并接受 3 剂 HPV 四价疫苗(在开始使用信迪利单抗前给予首剂,随后在 2 个月和 6 个月时给予 2 剂)。主要终点为客观缓解率(ORR)。采用 Simon 两阶段最优设计。
2019 年 10 月至 2022 年 10 月,共纳入 13 例 r/m CC 患者。ORR 为 53.8%(95%CI:25.1%80.8%),疾病控制率为 76.9%(95%CI:46.2%95.0%)。中位随访时间为 16.07 个月(范围:3.6448.2 个月),中位无进展生存期为 7.16 个月(95%CI:1.91无)。中位总生存期(OS)尚未达到(95%CI:9.89~无)。最常见的治疗相关不良事件(AE)是甲状腺功能减退(15.6%)。未观察到 3 级或以上的 AE。
本研究表明,信迪利单抗联合预防性 HPV 疫苗为标准治疗无反应或不耐受的 r/m CC 患者提供了一种有前景的治疗策略。
NCT04096911。