Regional trans-arterial immunotherapy combined with intravenous chemotherapy in patients with locally advanced cervical cancer as preoperative neoadjuvant therapy: A case series study 

Abstract Background: This study was to evaluate the effectiveness and safety of the preoperative regional trans-arterial immunotherapy combined with intravenous chemotherapy in patients with locally advanced cervical cancer (LACC). Methods: Trans-arterial programmed cell death receptor 1 (PD-1) monoclonal antibody infusion combined with intravenous paclitaxel-cisplatin chemotherapy was adopted as neoadjuvant therapy in six patients with primary LACC (stage IIB-IVA) who were willing to undergo surgical resection, and treatment effectiveness was evaluated according to the RECIST 1.1 criteria. If the local tumor was regressive and assessed as operable, surgery was performed, and postoperative adjuvant therapy was selected based on the histopathological findings. Results: One patient was discontinued the neoadjuvant therapy from the study due to an allergic reaction during the 2nd course and underwent surgical resection directly. Five patients achieved partial response after neoadjuvant therapy with an objective response rate of 100% and a surgical conversion rate of 100%. All patients had R0 resection. Serious adverse events did not occur during neoadjuvant therapy. The six patients were followed up for 15-30 months (median, 23.5 months) and none of them relapsed. Conclusions: Trans-arterial PD-1 monoclonal antibody infusion combined with intravenous paclitaxel-cisplatin as neoadjuvant therapy in patients with LACC showed a higher objective response rate, surgical conversion rate, and safety with satisfactory near-term outcomes. Further investigation is required to substantiate the outcome of regional trans-arterial infusion immunotherapy combined with intravenous chemotherapy as an alternative treatment modality for LACC.