Effect of neoadjuvant chemotherapy on the immune microenvironment of gynaecological tumours

Figures & data

Table 1. Completed clinical trials of chemotherapy combined with immune checkpoint inhibitor therapy.

Clinical Trials	Cancer types	Intervention	ORR(%)	OS(%)	PFS(%)
KEYNOTE826(III) [132]	Cervical Cancer	(1) pembrolizumab＋chemotherapy (2) placebo ＋chemotherapy	–	53.0 41.7	10.4 8.1
NCT03257267(III) [133]	Cervical Cancer	(1) cemiplimab (2) single-agent chemotherapy	–	12.0 8.5	2.8 2.9
NCT02580058(III) [134]	Ovarian Cancer	(1) avelumab (2) avelumab + PLD (3) PLD	–	18.2 18.4 17.4	1.9 3.7 3.5
NCT03038100(III) [135]	Ovarian Cancer	(1) atezolizumab + PC + bevacizumab (2) placebo + PC + bevacizumab	–		19.5 18.4
NCT02718417(III) [136]	Ovarian Cancer	(1) PC (2) PC + avelumab	terminate
NCT02901899(II) [137]	Ovarian Cancer	(1) pembrolizumab + gemcitabine	27.0	–
NCT02853318(II) [138]	Ovarian Cancer	(1) pembrolizumab + bevacizumab + cyclophosphamide	47.5	–	10
NCT02900560(II)	Ovarian Cancer	(1) pembrolizumab + azacytidine (2) pembrolizumab	–
NCT03899610(II) [139]	Ovarian Cancer	(1) durvalumab + tremelimumab + chemotherapy	100	–

Table 2. The changes and prognostic significance of NACT on the immune microenvironment of common gynaecological tumours.

Cancer types	Immune markers	Changes after NACT	Prognostic significance	References
Cervical cancer	CD4 CD8 CD20 CD56	Increase	None	[74]
Cervical cancer	CD3^+ CD4^+ PD-L1 TILs	Increase	None	[75]
Cervical cancer	intratumoural CD8 / stromal Foxp3	Increase	Increased intratumoural CD8 / peritumoural Foxp3 is an independent prognostic factor for PFS and OS.	[76,77]
Cervical cancer	PD-L1 CD8^+TIL	Increase	Patients with decreased PD-L1 expression had longer PFS.	[78]
Cervical cancer	PD-L1 PD-1 CD8	Increase	None	[79]
Cervical cancer	PD-L1	Increase	None	[80]
Cervical cancer	PD-LI	Decrease	None	[81]
Cervical cancer	T cells Macrophages Neutrophils	Decrease Increase Increase	None	[82]
Cervical cancer	NKs	Decrease	NKs can be used as a predictor of NACT efficacy.	[83]
Cervical cancer	NLR	Decrease	NLR can be used as a prognostic indicator after NACT.	[84]
Ovarian cancer	Functional cells Exhausted cells	Increase Increase	None	[88]
Ovarian cancer	CD8^+/Foxp3^+ CD3^+/Foxp3^+ CD68^+/CD163^+	Increase	CD8 ^+ / Foxp3 ^+, CD3 ^+ / Foxp3 ^+ and CD68 ^+ / CD163 ^+ can prolong PFS.	[89]
Ovarian cancer	CD4^+ CD8^+ granzyme B + Foxp3^+	Increase Increase Increase None	Low Foxp3 ^+ infiltration and high granzyme B ^+ were significantly associated with PFS.	[90]
Ovarian cancer	B cells	Increase	None	[91]
Ovarian cancer	CD8^+T Foxp3^+Tregs	Increase Increase	High CD8 ^+ T was not associated with longer survival.	[92]
Ovarian cancer	IL2Rahi-CCL22^+Tregs CD4 CD8	Increase Decrease Decrease	None	[93]
Ovarian cancer	CD3^+ CD8^+	Increase	High CD3^+ and CD8^+ cells are prognostic factors for PFS and OS.	[94,95]
Ovarian cancer	Monocytes Memory T cell receptor CD8	Increase	None	[96]
Ovarian cancer	CD8 PD-L1	Increase	None	[97]
Ovarian cancer	CD8 CD4 CD3 CD45^+7nk Foxp3^+7nLs PD-1 CTLA-4 PD-L1	None None None None Decrease Increase Increase Increase	None	[98]
Ovarian cancer	CD3^+ CD8^+ PD-1 CD20^+ TIL	Increase	None	[99]
Ovarian cancer	TILs PD-L1	Increase	Multivariate analysis: high sTILs (stromal TILs) after NACT was an independent prognostic factor for PFS, and the expression of ieTILs (epithelial TILs) and PD-L1 did not affect prognosis.	[100]
Ovarian cancer	TILs PD-L1	Increase	There was no correlation between TILs and PD-L1 and prognosis (PFS and OS) .	[101]
Ovarian cancer	TIL MHC-1	None Decrease	Upregulation of MHC-I during or after NACT will improve the prognosis of patients.	[102]
Ovarian cancer	NKs	Increase	The high proportion of CD16NKs in recurrent cancer is associated with better RFS and OS.	[103,104]
Ovarian cancer	Macrophages	Decrease	Matrix C3aR^+ CD68^+ macrophages are important predictors of PFS after NACT.	[105–107]
Ovarian cancer	Monocytes Cytotoxic T cells	Increase	Monocytes can be used as a driver of the immune environment.	[108]
Ovarian cancer	NLR	Decrease	NLR can be used as a predictor after NACT.	[109,110]

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Data availability statement

Data sharing is not applicable to this article as no new data were created or analysed in this study.