Successful neoadjuvant chemotherapy plus sintilimab for locally advanced cervical cancer: case series and review of the literature

Liu, Linlin; Deng, Xianbo; Guo, Shuang; Yang, Shouhua

doi:10.1186/s13000-023-01394-w

Table 3 Potential biomarkers for NACT short-term response prediction in cervical cancer

From: Successful neoadjuvant chemotherapy plus sintilimab for locally advanced cervical cancer: case series and review of the literature

Biomarkers	Country	Study	Tumor	No. patients	Therapy strategy	CR + PR Rate	P-value^a
Biomarkers	Country	Study	(Stage)	No. patients	Therapy strategy	or Median	P-value^a
Biomarkers of neoadjuvant chemotherapy
Primary tumor size (cm)
> 5 (vs. 4–5) [26]	China	Prospective	CC	157	Cis + VCR + BLM + Surg	72% (vs. 88%)	0.018
> 5 (vs. 4–5) [26]	China	Prospective	IB/IIA	157	Cis + VCR + BLM + Surg	72% (vs. 88%)	0.018
≥ 5 (vs. < 5) [8]	China	Retrospective	CC	219	PTX + CBP + Surg	62% (vs. 56%)	0.027
≥ 5 (vs. < 5) [8]	China	Retrospective	IB2/IIA2	219	PTX + CBP + Surg	62% (vs. 56%)	0.027
> 8 (vs. ≤ 8) [25]	China	RCT	CC	72	Cis + MC + 5-FU + Surg	42% (vs. 75%)	0.029
> 8 (vs. ≤ 8) [25]	China	RCT	IB2/IIB	72	Cis + MC + 5-FU + Surg	42% (vs. 75%)	0.029
Age (years)
≥ 35 (vs. < 35) [26]	China	Prospective	CC	157	Cis + VCR + BLM + Surg	83% (vs. 53%)	0.029
≥ 35 (vs. < 35) [26]	China	Prospective	IB/IIA	157	Cis + VCR + BLM + Surg	83% (vs. 53%)	0.029
≥ 35 (vs. < 35) [27]	China	Retrospective	SCC	851	Platinum-based + Surg	81% (vs. 88%)	0.041
≥ 35 (vs. < 35) [27]	China	Retrospective	IB1/IIB	851	Platinum-based + Surg	81% (vs. 88%)	0.041
Blood biomarkers
NLR	Rome	Prospective	CC	37	Cis + PTX + Surg	2.8 (vs. 4.41)	0.032
(response vs. nonresponse) [9]	Rome	Prospective	IB2/IVA	37	Cis + PTX + Surg	2.8 (vs. 4.41)	0.032
PLR	Rome	Prospective	CC	37	Cis + PTX + Surg	1.48 × 10⁵ (vs. 1.78 × 10⁵)	0.026
(response vs. nonresponse) [9]	Rome	Prospective	IB2/IVA	37	Cis + PTX + Surg	1.48 × 10⁵ (vs. 1.78 × 10⁵)	0.026
SIRI	China	Retrospective	CC	187	Cis + PTX + Surg	0.75 vs. 1.29	0.001
(response vs. nonresponse) [32]	China	Retrospective	IB2/IIA2	187	Cis + PTX + Surg	0.75 vs. 1.29	0.001
SCC-Ag > 3.5 ng/mL (vs. ≤ 3.5) [33]	China	Retrospective	CC	286	Cis + PTX/Cis + CPT	66% (vs. 82%)	0.010
SCC-Ag > 3.5 ng/mL (vs. ≤ 3.5) [33]	China	Retrospective	IB1/IIIB	286	Cis + PTX/Cis + CPT	66% (vs. 82%)	0.010
Other biomarkers
HIF-1α ≥ 6^b (vs. ≤ 4^b) [29]	China	Retrospective	CC	59	Cis + PTX	75% (vs. 95%)	0.025
HIF-1α ≥ 6^b (vs. ≤ 4^b) [29]	China	Retrospective	IIB/IIIB	59	Cis + PTX	75% (vs. 95%)	0.025
PRMT1 ≥ 6^b (vs. ≤ 4^b) [34]	Japan	Retrospective	CC	53	Cis + PTX	40% (vs. 69.6%)	0.033
PRMT1 ≥ 6^b (vs. ≤ 4^b) [34]	Japan	Retrospective	IIIB	53	Cis + PTX	40% (vs. 69.6%)	0.033
Galectin-1	China	Prospective	CC	35	Cis + 5-FU + MC	8.0 vs. 12.0	0.020
(response vs. nonresponse) [35]	China	Prospective	IB2-IIA2	35	Cis + 5-FU + MC	8.0 vs. 12.0	0.020
Integrin α5β1	China	Prospective	CC	35	Cis + 5-FU + MC	6.0 vs. 8.0	0.005
(response vs. nonresponse) [35]	China	Prospective	IB2-IIA2	35	Cis + 5-FU + MC	6.0 vs. 8.0	0.005
XPA ≥ 4^b (vs. ≤ 3^b) [36]	Japan	Retrospective	CC	56	Cis + PTX	41% (vs. 88%)	0.001
XPA ≥ 4^b (vs. ≤ 3^b) [36]	Japan	Retrospective	IIIA-IIIB	56	Cis + PTX	41% (vs. 88%)	0.001
UCP2 ≥ 8^b (vs. ≤ 6^b) [37]	Japan	Retrospective	CC	58	Cis + PTX	49% (vs. 76%)	0.041
UCP2 ≥ 8^b (vs. ≤ 6^b) [37]	Japan	Retrospective	IIIA-IIIB	58	Cis + PTX	49% (vs. 76%)	0.041
TBX2 ≥ 6^b (vs. ≤ 4^b) [38]	Japan	Retrospective	CC	46	Cis + PTX	36% (vs. 76%)	0.009
TBX2 ≥ 6^b (vs. ≤ 4^b) [38]	Japan	Retrospective	IIIA-IIIB	46	Cis + PTX	36% (vs. 76%)	0.009
EGFL7 ≥ 8^b (vs. ≤ 6^b) [28]	Japan	Retrospective	CC	63	Cis + PTX	19% (vs. 86%)	0.001
EGFL7 ≥ 8^b (vs. ≤ 6^b) [28]	Japan	Retrospective	IIIA-IIIB	63	Cis + PTX	19% (vs. 86%)	0.001
Biomarkers of immunotherapy
TMB-high (vs. TMB-low) [39]	China	Retrospective	CC	32	Cam + Apa	83% (vs. 43%)	< 0.050
TMB-high (vs. TMB-low) [39]	China	Retrospective	M/R/P	32	Cam + Apa	83% (vs. 43%)	< 0.050
PD-L1 ≥ 1% (vs. < 1%) [40]	America	Phase I trial	Solid tumor	132	Keytruda	22% (vs. 4%)	0.021
MMRd/MSI-H (vs. MMRp/MSS) [41]	Korea	Retrospective	Gynecologic cancers	1093	Keytruda + OPDIVO	29% (vs. 12%)	< 0.050

Abbreviations: CR complete response, PR partial response, CC cervical carcinoma, Cis cisplatin, VCR vincristine, BLM bleomycin, Surg surgery, SCC squamous cervical carcinoma, PTX paclitaxel, CBP carboplatin, MC mitomycin C, 5-FU 5-fluorouracil, NLR neutrophil to lymphocyte ratio, PLR platelet to lymphocyte ratio, SIRI systemic inflammatory response index, CPT irinotecan, HIF-1α hypoxia inducible factor-1alpha, PRMT1 protein arginine methyltransferase, XPA xeroderma pigmentosum complementation group A, UCP2 uncoupling protein 2, TBX2 T-box 2, EGFL7 epidermal growth factor-like domain 7, TMB tumor mutational burden, M/R/P metastatic/recurrent/persistent, Cam camrelizumab, Apa apatinib, PD-L1 programed death-ligand 1, Keytruda pembrolizumab, MMRd/MSI-H mismatch repair deficiency/high microsatellite instability, MMRp/MSS mismatch repair proficiency/microsatellite stable, OPDIVO nivolumab
Notes: ^aχ2 test; ^bThe expression levels of each biomarker were assessed quantitatively by immunohistochemical staining, using a weighted score method as follows: 0, ≤ 5%; 1, 5% to 25%; 2, 25% to 50%; 3, 50% to 75%; 4, > 75%

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ISSN: 1746-1596

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