Peripheral blood T-cell subsets and tumor markers predict immunotherapy efficacy in advanced cervical cancer

Advanced and recurrent cervical cancer presents significant treatment challenges, with immunotherapy emerging as a promising strategy. However, identifying patients most likely to benefit remains crucial to optimize outcomes and minimize unnecessary toxicity. Current standard-of-care often lacks precise predictive biomarkers, leading to varied responses. This study addresses the need for minimally invasive, accessible indicators to predict immunotherapy efficacy and prognosis, focusing on peripheral immune cell dynamics and established tumor markers like CA125 and SCCA.

This prospective study enrolled 50 patients with stage III-IVa or recurrent cervical cancer receiving first-line immunotherapy combined with chemo/radiotherapy. Researchers analyzed baseline CD4+/CD8+ T-cell percentages and post-treatment (after one course) levels of CA125, SCCA, T-cell subsets, and PD-1 expression on T-cells. Logistic regression compared 36 responders vs. 14 non-responders for treatment efficacy, while Cox regression assessed prognosis, with 26 patients experiencing disease progression or death.

Treatment response was significantly associated with several peripheral blood indicators. At baseline, a higher CD4+ T-cell percentage predicted better response (p < .05). Post-treatment, lower CA125 and SCCA levels, increased CD8+ T-cell percentage, and reduced PD-1 expression on both CD4+ and CD8+ T-cells were all significantly linked to treatment efficacy (all p < .05). Prognostic factors identified by Cox regression included these same markers, plus post-treatment CD4+ T-cell percentage. Optimal responders consistently showed a favorable immune profile.

Optimal responders to immunotherapy for advanced cervical cancer exhibited high baseline CD4+ T-cells, low post-treatment CA125/SCCA, elevated CD4+/CD8+ T-cells, and reduced PD-1 expression (all p < .05). These findings highlight the dynamic interplay of immune cells and tumor markers in predicting immunotherapy success.