Systematic review and meta-analysis of neoadjuvant chemotherapy plus ICIs for locally advanced cervical cancer

Neoadjuvant immune checkpoint inhibitors enable organ preservation strategies and surgical de-escalation in many cancer types. A systematic review and meta-analysis of phase 2 and 3 trials published through March 2025 evaluated response rates and safety of neoadjuvant chemotherapy plus immune checkpoint inhibitors in locally advanced cervical cancer (LACC). Three studies involving 162 patients were included in the meta-analysis. The pooled objective response was 95.5% (95% CI 90.8-98.6), whereas the pooled pathological complete response (pCR) rate was 45.5% (27.7-63.2). Grade 3 or higher adverse events occurred at a pooled rate of 35.5%. Sensitivity analysis confirmed the reliability of the meta-analytic findings. The authors conclude that these results provide theoretical basis for further studies in reducing the scope of surgery to minimize complications or preserve fertility in LACC patients.