Immunotherapy for Cervical Cancer

Immunotherapy is the use of medicines to boost a person’s own immune system to recognize and destroy cancer cells more effectively. Immunotherapy typically works on specific proteins involved in the immune system to enhance the immune response. They have different and sometimes less severe side effects than chemotherapy. 

Some immunotherapy drugs, for example, monoclonal antibodies, work in more than one way to control cancer cells and may also be considered targeted therapy because they block a specific protein on the cancer cell to keep it from growing.

Immunotherapy can sometimes be used to treat cervical cancer.

Immune checkpoint inhibitors

An important part of the immune system is its ability to keep itself from attacking the body's normal cells. To do this, it uses “checkpoints” – proteins on immune cells that need to be turned on (or off) to start an immune response. Cancer cells sometimes use these checkpoints to avoid being attacked by the immune system. Newer drugs that target these checkpoints are being used as cancer treatments.

Pembrolizumab (Keytruda) targets PD-1, a protein on immune system cells called T cells that normally helps keep these cells from attacking other cells in the body. By blocking PD-1, these drugs boost the immune response against cancer cells. This can shrink some tumors or slow their growth.

Before pembrolizumab can be used, a lab test might need to be done on the cancer cells to show they have at least a certain amount of the PD-L1 protein.

If enough PD-L1 protein is detected, pembrolizumab can be used:

• By itself for cervical cancer that has come back or that has spread while getting chemotherapy or after chemotherapy.
• Along with chemotherapy, with or without bevacizumab, for cervical cancer that is not shrinking with current treatment, has come back, or has spread to distant sites.

Regardless of whether there are PD-L1 proteins detected on the cancer cells, pembrolizumab can be used:

•  Along with concurrent chemoradiation for advanced stage cervical cancer.

This immunotherapy drug is given as an intravenous (IV) infusion every 3 or 6 weeks.

Possible side effects of immunotherapy

Side effects of immunotherapy drugs can include fatigue, fever, nausea, headache, skin rash, loss of appetite, constipation, joint/muscle pain, and diarrhea.

Other, more serious side effects occur less often. These drugs work by basically removing the brakes on the body’s immune system. Sometimes the immune system starts attacking other parts of the body, which can cause serious or even life-threatening problems in the lungs, intestines, liver, hormone-making glands, kidneys, or other organs.

It’s very important to report any new side effects to your health care team right away. If you do have a serious side effect, treatment may need to be stopped and you may be given high doses of corticosteroids to suppress your immune system.