Efficacy and Safety of Immune Checkpoint Inhibitors for Cervical Cancer: A Systematic Review and Meta-Analysis

Background: Immune checkpoint inhibitor (ICI) therapies have shown promising potential in cervical cancer immunotherapy. However, its therapeutic efficacy remains to be further evaluated. Our goal was to evaluate the efficacy and safety of ICI therapies in cervical cancer through a meta-analysis of relevant studies. Methods: Databases, including PubMed, Embase, Web of Science, and Cochrane Central Register of Controlled Trials, were systematically searched for studies on the efficacy and safety of ICI therapy in cervical cancer to 19 January 2024. Outcomes including objective response rate (ORR), progression-free survival (PFS), overall survival (OS), the Europe Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Core 30 (QLQ-C30) scores and adverse events (AEs) were extracted for analysis. Results: Seven studies involving a total of 2514 patients were enrolled in this meta-analysis. ICI therapies significantly extended OS [hazard ratio (HR) = 0.68, 95% confidence interval (95% CI) (0.60, 0.77); p < 0.0001] and PFS [HR = 0.69, 95% CI (0.61, 0.78); p < 0.0001]. There was no significant difference between ICI therapies and conventional therapies in ORR [HR = 1.29, 95% CI (0.86, 1.94); p = 0.16], in QLQ-C30 score [standardized mean difference (SMD) = 0.09, 95% CI (-0.36, 0.54); p = 0.48], and in grade 3 or worse AEs [HR = 0.96, 95% CI (0.88, 1.05); p = 0.28]. Sensitivity analysis confirmed the stability of these findings. Conclusions: ICI therapies improve OS and PFS in cervical cancer patients with a safety profile comparable to conventional therapies. Nevertheless, further studies and randomized clinical trials are necessary to validate these results.