Complete response of metastatic cervical adenocarcinoma treated with chemoradiotherapy followed by pembrolizumab: A case report

Abstract

Introduction: Metastatic adenocarcinoma of the uterine cervix is challenging to treat, particularly if there is persistent disease following surgery and chemoradiotherapy. In recent years, advances in checkpoint inhibitor-based immunotherapy have shown promise in patients in a variety of cancers. Only limited information is available concerning treatment of cervical adenocarcinoma with checkpoint inhibitors. Case Report: This case report details a patient with metastatic cervical adenocarcinoma with persistent disease following surgical resection. Subsequent treatment with cisplatin, paclitaxel, and bevacizumab therapy with concurrent radiotherapy resulted in a partial response. The patient was subsequently treated with pembrolizumab. After 3 cycles of treatment the patient achieved a stable radiologic complete remission, which continues after treatment discontinuation. Conclusion: This result suggests that chemoradiotherapy with either concurrent or sequential administration of a PD-1 antibody, such as pembrolizumab, may have significant activity as treatment of metastatic or unresectable cervical adenocarcinoma. Further prospective clinical testing appears warranted. Wolfram Samlowski1,2, Mark Chang2, Raul Meoz3, Amin Hedayat4 Affiliations: 1Comprehensive Cancer Centers of Nevada, Las Vegas, NV, USA; University of Nevada, Reno, NV, USA; 2University of Nevada Las Vegas (UNLV), Las Vegas, NV, USA; 3Comprehensive Cancer Centers of Nevada, Las Vegas, NV, USA; 4Associated Pathologists Chartered Laboratories, American Melanoma Institute, University of Nevada Las Vegas (UNLV), Las Vegas, NV, USA. Corresponding Author: Wolfram Samlowski, MD, Comprehensive Cancer Centers of Nevada, 9280 W. Sunset Rd, Suite 100, Las Vegas, NV 89148, USA; Email: [email protected] Received: 19 September 2020 Accepted: 02 February 2021 Published: 10 March 2021 PEER REVIEWED | OPEN A CE S