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Mixed Proffered paper and Mini oral session: Gynaecological cancers

286MO - Efficacy of low dose nivolumab in recurrent / metastatic cervical cancer

Date

01 Dec 2023

Session

Mixed Proffered paper and Mini oral session: Gynaecological cancers

Topics

Tumour Site

Cervical Cancer

Presenters

Sowmica Devabhaktuni

Citation

Annals of Oncology (2023) 34 (suppl_4): S1584-S1598. 10.1016/annonc/annonc1383

Authors

S. Devabhaktuni1, A. Singh2, J.T. Georgy2, J. Antonisamy3, D.B. Thumaty4, A.O. John4

Author affiliations

  • 1 Medical Oncology Dept., CMC - Christian Medical College Hospital Vellore, 632004 - Vellore/IN
  • 2 Medical Oncology Department, CMC - Christian Medical College Hospital, 632004 - Vellore/IN
  • 3 Medical Oncology Department, CMC - Christian Medical College Hospital Vellore, 632004 - Vellore/IN
  • 4 Department Of Medical Oncology, CMC - Christian Medical College Hospital, 632004 - Vellore/IN

Resources

This content is available to ESMO members and event participants.

Abstract 286MO

Background

Cervical cancer is the second most common cancer in women in India. Recurrent / metastatic (R/M) cervical cancer carries a poor prognosis with median overall survival of 11 months with chemotherapy alone. Checkpoint inhibitors added to chemotherapy have improved survival. However, the current approved dose is accessible to only 1-3% of patients in low- and middle-income countries because of their cost. Nivolumab does not have a dose-response relationship; therefore, a low dose regimen may be a viable option to reduce financial burden and improve access.

Methods

This is a retrospective study from a single tertiary centre in India from 1/3/2020 to 30/6/2023. Patients with R/M cervical cancer who received low dose Nivolumab as they could not afford to pay for standard Nivolumab dose were analyzed. Response rates and Progression free survival (PFS) were measured.

Results

A total of 20 patients who received low dose Nivolumab were identified during the study period whose mean age was 54.3 years. 75% had ECOG of Patient and tumor characteristics

Characteristic nivolumab
N %
Age (years)
40-49 8 40
50-59 6 30
60-69 5 25
70-79 1 5
Performance status
0,1 15 75
>/= 2 5 25
Histology
Squamous 14 70
Non- squamous 6 30
Prior surgery
Yes 17 85
No 3 15
Prior RT
Yes 17 85
No 3 15
Prior chemotherapy
None 6 30
I line 11 55
II lines 3 15
Backbone chemotherapy with Nivolumab
Platinum based 11 55
None 5 25
Others 4 2

The average number of doses received were 4.75 and the mean dose received was 0.84mg/kg. Overall responses were seen in 10 patients (50%) out of which 5 (50%) had stable disease and 5(50%) had a complete response. Median progression free survival was 7.97 months. Treatment related adverse events (TRAE) were seen in 8 patients (40%), out of which most of them are grade 1 and 2. 3 (15%) patients had grade 3 TRAE. No grade 4 and 5 adverse events were recorded.

Conclusions

In patients with R/M cervical cancer, Low dose Nivolumab is effective with manageable toxicity. It can help reduce financial toxicity and make it accessible to more patients especially in low- and middle-income countries where the burden of this disease is higher.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

S. Devabhaktuni.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.

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