Abstract:

Background and purpose: The treatment of recurrent, metastatic, and treatment-naïve advanced cervical cancer remains challenging. Immunotherapy in combination with chemotherapy and targeted therapy has shown preliminary clinical benefits, however, current evidence remains limited. This study aimed to evaluate the impact of camrelizumab combined with chemotherapy and targeted therapy on the prognosis of patients with recurrent, metastatic, and treatment-naïve advanced cervical cancer. Methods: In this study, we conducted a retrospective analysis of the clinical data from 130 patients with recurrent, metastatic, and treatment-naïve advanced cervical cancer admitted to Minhang Branch of Fudan University Shanghai Cancer Center from 2019 to 2025. The patients were categorized into the observation group (n=70), which included those who received camrelizumab with or without chemotherapy and targeted therapy, and the control group (n=60), including those who received chemotherapy and targeted therapy. Survival analysis was performed using the log-rank test, and univariate and multivariate Cox regression analyses were conducted to explore prognostic factors. This study was approved by the Ethics Committee of the Minhang Branch of Fudan University Shanghai Cancer Center[Approval number: (2024) Review No. (015)] and all informed consents were exempted. Results: The objective response rate (ORR) in the observation group was 72.9%, and the disease control rate (DCR) was 80.0%, which were significantly higher than those in the control group with an ORR of 20.0% (χ²=36.1, P<0.001) and a DCR of 40.0% (χ²=21.8, P<0.001). The median progression-free survival (PFS) in the observation group was not reached, significantly longer than that in the control group of 7.0 months (P<0.001). Multivariate Cox regression analysis identified camrelizumab treatment as an independent protective factor for PFS (P<0.001). Age, site of recurrence/metastasis, initial treatment approach, and histopathological type were not significantly associated with PFS. In the observation group, adverse events of grade 3 or higher were reported in 29 patients (41.4%), which primarily included vasculitis, hypothyroidism, hypersensitivity reactions, and diarrhea. Conclusion: The use of camrelizumab significantly improved treatment outcomes and prognosis for patients with recurrent, metastatic, and treatment-naïve advanced cervical cancer, with significantly improved progression-free survival. Although a certain proportion of patients experienced adverse events of grade 3 or higher, the overall safety profile was acceptable. In clinical practice, immunotherapy offers a more effective treatment option for patients.

Key words: Cervical cancer, Immunotherapy, Chemotherapy, Targeted therapy, Recurrence, Metastasis, Treatment-naive, Prognosis