Work

Efficacy and safety of PD-1/PD-L1 inhibitors plus chemotherapy ± bevacizumab for recurrent or metastatic cervical cancer: a systematic review and meta-analysis of randomized controlled trials

Year: 2026

Type: review

Study designs: Systematic Review, Meta-Analysis

Abstract: Background: The efficacy of adding PD-1/PD-L1 inhibitors to chemotherapy ± bevacizumab in recurrent or metastatic cervical cancer is under active investigation. Objective: To systematically evaluate the efficacy and safety of PD-1/PD-L1 inhibitors combined with chemotherapy ± bevacizumab in this setting through a meta-analysis of randomized controlled trials (RCTs). Methods: A systematic search of PubMed, Embase, Web of Science, Cochrane Library, Scopus, and ClinicalTrials.gov was conducted for RCTs published up to January 14, 2026. Primary outcomes were overall survival (OS) and progression-free survival (PFS); hazard ratios (HRs) were derived from reconstructed Kaplan-Meier curves. Results: Six RCTs involving 2,242 patients were included: 1,131 received PD-1/PD-L1 inhibitors plus chemotherapy ± bevacizumab, and 1,111 received chemotherapy ± bevacizumab alone. The combination regimen significantly prolonged median OS (28.7 vs. 19.4 months) and median PFS (12.0 vs. 8.7 months). Pooled risk ratios (RRs) for complete response, partial response, stable disease, progressive disease, and objective response rate were 1.606 (95% CI, 1.333-1.936), 1.127 (95% CI, 0.994-1.277), 0.733 (95% CI, 0.612-0.878), 0.460 (95% CI, 0.305-0.695), and 1.235 (95% CI, 1.153-1.322), respectively. The risk of any-grade adverse events did not differ significantly between groups (RR 0.999, 95% CI 0.991-1.008), whereas the combination was associated with an increased risk of grade ≥3 adverse events (RR 1.069, 95% CI 1.019-1.121). Frequently reported adverse reactions included nausea, anemia, constipation, arthralgia, neutropenia, hypertension, alopecia, and peripheral neuropathy. Conclusion: In patients with recurrent or metastatic cervical cancer, the addition of PD-1/PD-L1 inhibitors to chemotherapy ± bevacizumab significantly improves OS and PFS, though with a modest increase in high-grade toxicity. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/, identifier CRD420261472748.

Source: Frontiers in Immunology

DOI: 10.3389/fimmu.2026.1972995

Authors: Raoshan Luo, Minghong Li, Li Ma, Zhilong Huang

Institutions: Wuzhou Medical College, First Affiliated Hospital of Guangxi University of Science and Technology, Guangzhou Women and Children Medical Center, Guangzhou Medical University

Language: English

Topic: Endometrial and Cervical Cancer Treatments

Subfield: Obstetrics and Gynecology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,801