Zimberelimab combined with systemic therapy extended tumor control in post-radiotherapy cervical cancer with brain metastases: A case report

J Obstet Gynaecol Res. 2024 Apr;50(4):740-745. doi: 10.1111/jog.15887. Epub 2024 Jan 10.

Abstract

Out of the total cases of cervical cancer, brain metastases (BMs) are relatively rare, with an estimated incidence rate of 0.63% (range: 0.1%-2.2%). Additionally, BMs prognosis remains poor, and the average patient survival time following a BM diagnosis is 3 to 5 months. Few studies have addressed the effect of programmed cell death-1 inhibitors against BMs in cervical cancer, although they are an established option for recurrent/metastatic disease. Hence, we report a case involving a 54-year-old post-surgery patient with cervical cancer with a body mass index of 19.5 kg/m2 and Eastern Collaborative Oncology Group (ECOG) performance status of 3; the disease recurred with BMs 1 year later. Intensity-modulated radiation therapy concurrent with temozolomide and bevacizumab was initiated, following which zimberelimab immunotherapy combined with anlotinib was administered to extend tumor control. The patient had a progression-free survival duration of 10 months, the tumor response was assessed as a partial response based on the evaluation criteria for solid tumors (RECIST1.1), and the ECOG status improved to 1 after therapy. These findings suggest that immunotherapy-based combination therapy following radiotherapy may be a good choice for patients with cervical cancer and BMs.

Keywords: brain metastases; cervical adenocarcinoma; chemo‐free therapy; immunotherapy.

Publication types

  • Case Reports

MeSH terms

  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Brain Neoplasms* / drug therapy
  • Brain Neoplasms* / radiotherapy
  • Female
  • Humans
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Uterine Cervical Neoplasms* / drug therapy

Substances

  • zimberelimab
  • Antibodies, Monoclonal, Humanized