PD-1 Inhibition With Camrelizumab in Cervical Cancer

OBJECTIVES: Cervical cancer is the fourth leading cause of cancer mortality in women worldwide. PD-L1 is expressed in 34.4% to 96% of cervical cancers. Camrelizumab is an anti-PD-1 IgG4 antibody with antitumor activity. This study evaluates the efficacy and safety of camrelizumab in cervical cancer. METHODS: A systematic search of PubMed, Embase, Web of Science, Cochrane Library, Ovid MEDLINE, and Scopus was performed to identify studies of pathologically confirmed cervical cancer treated with camrelizumab alone or in combination with chemotherapy or VEGFR-TKIs, including apatinib or famitinib. Eligible studies included randomized trials, single-arm trials, cohort studies, and case-control studies. Pooled proportions with 95% CIs were calculated using R version 4.4.1. Heterogeneity was assessed using I2, and evidence certainty was evaluated using GRADE. RESULTS: Eight studies comprising 382 patients were included. Camrelizumab was evaluated as monotherapy, with chemotherapy, or with VEGFR-TKIs. The pooled objective response rate (ORR) was 0.62 (95% CI: 0.32-0.85). The disease control rate (DCR), assessed in 7 studies including 297 patients, was 0.83 (95% CI: 0.60-0.94). The pooled partial response (PR) rate was 0.45 (95% CI: 0.29-0.62), while the complete response (CR) rate was 0.15 (95% CI: 0.10-0.23). Progressive disease (PD) outcomes were reported in a cohort of 297 patients, corresponding to a proportion of 0.16 (95% CI: 0.06-0.36), and stable disease (SD) demonstrated a pooled proportion of 0.30 (95% CI: 0.19-0.44). Commonly reported adverse events included neutropenia, anemia, leukopenia, hypertension, lymphopenia, and myelosuppression. CONCLUSIONS: Camrelizumab demonstrates clinically meaningful antitumor activity in cervical cancer, particularly in combination regimens, though toxicity requires careful monitoring.