PD-1 inhibition with camrelizumab in cervical cancer: A systematic review and meta-analysis.

Abstract

e17515 Background: Cervical cancer is the fourth leading cause of cancer mortality in women worldwide. PD-L1 is expressed in 34.4-96% of cervical cancers. Camrelizumab is a high-affinity humanized anti-PD-1 IgG4 antibody with anti-tumour activity. This study systematically evaluates the pooled efficacy and safety of Camrelizumab in cervical cancer. Methods: A literature search was performed across PubMed, Embase, Web of Science, the Cochrane Library, Ovid MEDLINE, and Scopus. Randomized controlled trials, single-arm trials, prospective or retrospective cohort studies, and case-control studies with pathologically confirmed cervical cancer patients treated with Camrelizumab as monotherapy or in combination with chemotherapy or VEGFR-TKIs (Apatinib or Famitinib) were included. Statistical analyses were performed using R (version 4.4.1) with pooled proportions and corresponding 95% confidence intervals (CI) calculated for each outcome. Statistical heterogeneity was assessed using the I² statistic. A sensitivity analysis was conducted using a leave-one-out approach and combined results were presented using forest and funnel plots. Results: The meta-analysis included nine studies comprising 427 patients evaluating the efficacy of Camrelizumab either used as monotherapy, with chemotherapy, or with VEGFR-TKIs (Apatinib or Famitinib) in cervical cancer. Given the predominance of single-arm studies and high heterogeneity among them, random-effects models were applied throughout. 52 patients achieved complete response (CR) with a pooled CR rate of 0.14 (95% CI 0.09-0.22). Disease control rate (DCR) was assessed in eight studies including 342 patients with a proportion of 0.81 (95% CI 0.64-0.91). The proportion of objective response rate (ORR) was 0.60 (95% CI 0.36-0.80). Progressive disease (PD) outcomes were reported in a cohort of 342 patients corresponding to a proportion of 0.16 (95% CI 0.07-0.31). The pooled partial response (PR) rate was 0.46 (95% CI 0.32-0.60). 103 of 342 patients achieved stable disease (SD), resulting in a proportion of 0.30 (95% CI 0.21-0.41). 7 studies reported grade ≥3 adverse events and 2 reported treatment-related deaths. Commonly reported adverse events included neutropenia, anaemia, leukopenia, hypertension, lymphopenia, and myelosuppression. Conclusions: This systematic review and meta-analysis indicates that PD-1 inhibition with Camrelizumab demonstrates clinically meaningful antitumor activity in cervical cancer, both as monotherapy and in combination regimens, addressing a disease with limited effective therapeutic options. The consistency of efficacy signals across diverse study designs supports Camrelizumab as an active immunotherapeutic approach in this setting.