Circulating immune cell profiling in advanced cervical and endometrial cancer patients treated with PD-1 blockade, radiotherapy, and immune modulation in the PRIMMO trial
Abstract
Background: Immune checkpoint blockade (ICB) has revolutionized cancer treatment, including gynecological cancers, yet durable responses are observed only in subsets of patients. To improve efficacy, ICB is increasingly combined with complementary approaches. Although tissue-based biomarkers provide valuable information, their invasiveness and inability to capture systemic immune changes limit their utility. Peripheral blood offers a noninvasive alternative, but immune cell profiling in advanced cervical cancer (CC) and endometrial (EC) patients receiving ICB-based therapy remain underexplored.
Methods: This exploratory translational study of the PRIMMO clinical trial (https://clinicaltrials.gov/search?id=%22NCT03192059%22) analyzed blood-based immune profiles from advanced CC (n=19) and EC (n=24) patients treated with an ICB-based regimen. Peripheral blood was collected at inclusion (baseline), on-treatment (week 7), and post-treatment (week 26 or earlier (< week 26) in case of earlier disease progression). Immune cell subsets and selected systemic immune mediators were assessed by multicolor flow cytometry and ELISA.
Results: At baseline, CTLA-4+PD-1+CD4+ T cells and CD161+CD56+CD16+ NK cells were associated with survival outcomes only, while the combined immune score was associated with both treatment response and survival outcomes. During treatment, responders exhibited relatively stable immune profiles at both early and late treatment time points. In contrast,…
How strong is the evidence?
Evidence Hub reads this as a clinical trial, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 24 participants or records.
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