Durable progression-free survival with first-line sintilimab plus chemotherapy followed by sintilimab maintenance in PD-L1-high recurrent cervical cancer: a case report

Background Recurrent advanced cervical cancer has an extremely poor prognosis, with a 5-year survival rate of only 20%. Cervical cancer is closely linked to persistent infection with high-risk Human papillomavirus and its tumor microenvironment is often enriched with immune cell infiltrates, especially CD8+ T cells, indicating a degree of immunogenicity. Immunotherapy can prolong progression-free survival and overall survival in a subset of these patients, with the greatest benefit observed in those with programmed death-ligand 1positive tumors or squamous cell histology. Sintilimab is a fully human IgG4κ anti-PD-1 monoclonal antibody that has yielded positive results in lymphomas and several advanced solid tumors. However, published data on its use as a first-line therapy for recurrent advanced cervical cancer remain scarce. Case presentation We report a case involving a 51-year-old Chinese woman whose advanced cervical cancer recurred with bilateral lung metastases 3 years after radical surgery and radiotherapy. First-line treatment with sintilimab plus chemotherapy, followed by maintenance therapy with sintilimab, achieved a complete response and progression-free survival of 37.5 months. Only grade 2 or lower immune-related adverse events occurred: grade 1 subclinical hyperthyroidism and grade 2 leukopenia. Conclusions Maintenance therapy with sintilimab after first-line treatment with sintilimab plus chemotherapy can confer substantial clinical benefits in patients with recurrent advanced cervical cancer, with a favorable safety profile and no serious adverse events observed, warranting further prospective investigation.