Neoadjuvant immunotherapy before chemoradiation in cervical squamous carcinoma

A phase II trial recently published on Nature Communications shows that a neoadjuvant immunotherapy before standard chemoradiation can improve complete response at treatment completion in patients with cervical squamous carcinoma, priming tumors to a better response to standard therapy.

The window-of-opportunity COLIBRI phase II trial explored the effect of immune checkpoint blockade on the tumor immune microenvironment, aiming to understand how a dual blockade with nivolumab and ipilimumab affects the T-cell immune infiltrate in cervical cancer and how sequencing immunotherapy before and after chemoradiotherapy affects the immune response and anti-tumor efficacy. A total of 40 patients with locally advanced cervical carcinoma received one cycle of nivolumab-plus-ipilimumab immunotherapy before standard chemoradiation, followed by maintenance nivolumab. Results showed a significant remodeling of the tumor microenvironment following immune checkpoint blockade, including increased tumor infiltration by CD8+ cells; moreover, objective response rates were 13% immediately after combination immunotherapy, 98% (65% complete response) after chemoradiation, and 90% at treatment completion. «The COLIBRI trial in locally advanced cervical carcinoma demonstrates the feasibility and tolerability of dual nivolumab plus ipilimumab immune checkpoint blockade before chemoradiation followed by up to 6 months of maintenance nivolumab after chemoradiation», authors say. «Results from COLIBRI, combined with ongoing translational research, support further evaluation of neoadjuvant sequencing strategies for high-risk patients with locally advanced cervical carcinoma. The randomized phase II COLIBRI-2 trial is exploring nivolumab with or without the LAG3 inhibitor relatlimab as induction therapy before standard chemoradiation for these patients».