Prognostic analysis of nimotuzumab combined with concurrent chemoradiotherapy for locally advanced cervical cancer: a multicenter real-world study

Nimotuzumab is a monoclonal antibody against EGFR. The therapeutic efficacy of nimotuzumab in cervical cancer treatment remains inconclusive, with current evidence insufficient to establish a definitive clinical benefit. Therefore, this study compares the efficacy and safety of nimotuzumab combined with concurrent chemoradiotherapy (CCRT) and CCRT in locally advanced cervical cancer (LACC). Information on patients with stage IIB-IVA cervical cancer who received CCRT combined with nimotuzumab or CCRT alone at five cancer centers from January 2021 to December 2022 were collected. Propensity score (PS) matching analysis was used to compare nimotuzumab group and no-nimotuzumab group. Clinical outcomes were analyzed. There were 195 patients enrolled. The 2-year overall survival (OS) and progression-free survival (PFS) rates were 92.5% and 89.5%, respectively. The objective response rate (ORR) was 90.8%. There were 60 patients in the nimotuzumab group and 135 patients in the no-nimotuzumab group. The nimotuzumab group had a better CR rate (51.7% vs. 26.7%, P = 0.001) and ORR (98.3% vs. 87.4%, p = 0.015) compared to the no-nimotuzumab group. After PS matching, there were 54 patients in each group. There were no significant differences in 2-year OS rate and PFS rate between the two groups before and after matching. However, the nimotuzumab group had also a better CR rate and ORR compared to the no-nimotuzumab group after matching. The incidence of grade 3-4 anemia was relatively higher in nimotuzumab group than in no-nimotuzumab group after matching, while no difference was observed in other adverse events between the two groups. The combination of nimotuzumab and CCRT for LACC improved CR rate and ORR, without increasing side effects, which might become a potential treatment strategy for LACC patients.