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Review

Overview of Immune Checkpoint Inhibitors in Gynecological Cancer Treatment

1
Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
2
Division of Gynaecology and Obstetrics, University Medical Centre, 1000 Ljubljana, Slovenia
3
Department of Medical Oncology, Institute of Oncology Ljubljana, 1000 Ljubljana, Slovenia
*
Author to whom correspondence should be addressed.
Academic Editor: Rebecca A Previs
Cancers 2022, 14(3), 631; https://doi.org/10.3390/cancers14030631
Received: 6 January 2022 / Revised: 24 January 2022 / Accepted: 26 January 2022 / Published: 27 January 2022
(This article belongs to the Special Issue Immune Microenviroment in Gynecologic Malignancies)
Recently, cancer treatment has been revolutionized by introduction of immunotherapy—drugs that target body’s immune system to attack cancer. Most clinically used drugs stop the mechanisms that dampen immune response. These drugs are called immune checkpoint inhibitors (ICIs). ICIs in gynecological cancers are most effective for treating uterine endometrial cancer, but less so far ovarian, uterine cervical or vulvar cancer. However, combining ICIs with other drugs has yielded good results in some studies in these cancers. Stopping mechanisms that dampen immune response can produce severe side effects, as has been seen with the use of ICIs. Therefore, selection of patients that would benefit the most from ICI therapy is of paramount importance. This can be done by analysing tumour characteristics either by looking at protein expression, genetic changes and even constitution of faecal microbiota, these properties are called biomarkers. It is not entirely known which biomarkers predict response most accurately, and this varies by cancer type. In this article, we review mechanisms of action of ICIs, selected biomarkers and latest clinical trials of ICIs in gynecological cancers.
In the last ten years, clinical oncology has been revolutionized by the introduction of oncological immunotherapy, mainly in the form of immune checkpoint inhibitors (ICIs) that transformed the standard of care of several advanced solid malignancies. Using ICIs for advanced gynecological cancers has yielded good results, especially for endometrial cancer. In ovarian or cervical cancer, combining ICIs with other established agents has shown some promise. Concurrently with the clinical development of ICIs, biomarkers that predict responses to such therapy have been discovered and used in clinical trials. The translation of these biomarkers to clinical practice was somewhat hampered by lacking assay standardization and non-comprehensive reporting of biomarker status in trials often performed on a small number of gynecological cancer patients. We can expect increased use of ICIs combined with other agents in gynecological cancer in the near future. This will create a need for reliable response prediction tools, which we believe will be based on biomarker, clinical, and tumor characteristics. In this article, we review the basic biology of ICIs and response prediction biomarkers, as well as the latest clinical trials that focus on subgroup effectiveness based on biomarker status in gynecological cancer patients. View Full-Text
Keywords: immune check-point inhibitor; biomarker; endometrial cancer; ovarian cancer; uterine cervical cancer; vulvar cancer; treatment response prediction immune check-point inhibitor; biomarker; endometrial cancer; ovarian cancer; uterine cervical cancer; vulvar cancer; treatment response prediction
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MDPI and ACS Style

Pirš, B.; Škof, E.; Smrkolj, V.; Smrkolj, Š. Overview of Immune Checkpoint Inhibitors in Gynecological Cancer Treatment. Cancers 2022, 14, 631. https://doi.org/10.3390/cancers14030631

AMA Style

Pirš B, Škof E, Smrkolj V, Smrkolj Š. Overview of Immune Checkpoint Inhibitors in Gynecological Cancer Treatment. Cancers. 2022; 14(3):631. https://doi.org/10.3390/cancers14030631

Chicago/Turabian Style

Pirš, Boštjan, Erik Škof, Vladimir Smrkolj, and Špela Smrkolj. 2022. "Overview of Immune Checkpoint Inhibitors in Gynecological Cancer Treatment" Cancers 14, no. 3: 631. https://doi.org/10.3390/cancers14030631

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