Evidence map›Paper›PMID 41296221›Full record

ArticleInternational journal of clinical oncology2026

Real-world multicenter study of immune checkpoint inhibitors in advanced cervical cancer across HPV-associated and HPV-independent subtypes.

Kazuhiro Ko, Mayu Fukuda, Koji Yamanoi, Nobutaka Hayashi, Hisateru Yasui, Takuma Hayashi, Yoshihiro Yakushijin, Takehiko Tsumura, Atsushi Shirakawa, Chiho Nakashima and 14 more

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in International journal of clinical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

24 authors.

Kazuhiro Ko *Department of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, 54 Kawahara-Cho, Shogoin, Sakyo-Ku, Kyoto-Shi, Kyoto, Japan.
Mayu Fukuda *Department of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, 54 Kawahara-Cho, Shogoin, Sakyo-Ku, Kyoto-Shi, Kyoto, Japan.
Koji YamanoiDepartment of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, 54 Kawahara-Cho, Shogoin, Sakyo-Ku, Kyoto-Shi, Kyoto, Japan. kojiymni@kuhp.kyoto-u.ac.jp.ORCID http://orcid.org/0000-0002-1240-5422
Nobutaka HayashiDepartment of Obstetrics and Gynecology, Kobe City Medical Center General Hospital, Kobe, Japan.
Hisateru YasuiDepartment of Medical Oncology, Kobe City Medical Center General Hospital, Kobe, Japan.
Takuma HayashiClinical Research Center, National Hospital Organization Kyoto Medical Center, Kyoto, Japan.
Yoshihiro YakushijinDepartment of Clinical Oncology, Ehime University Graduate School of Medicine, Matsuyama, Japan.
Takehiko TsumuraDepartment of Medical Oncology, Osaka Red Cross Hospital, Osaka, Japan.
Atsushi ShirakawaDepartment of Medical Oncology, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan.
Chiho NakashimaDivision of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan.
Yoshinori ImamuraCancer Care Promotion Center, University of Fukui Hospital, Fukui, Japan.
Chikako YamauchiDepartment of Radiation Oncology, Shiga General Hospital, Moriyama, Japan.
Toshio ShimizuDepartment of Medical Oncology, Wakayama Medical University, Wakayama, Japan.
Takahito AshiharaDepartment of Obstetrics and Gynecology, Kyoto-Katsura Hospital, Kyoto, Japan.
Nobuhiro ShibataDepartment of Clinical Oncology, Kansai Medical University Hospital, Hirakata, Japan.
Takeshi KotakeDepartment of Medical Oncology, Tenri Hospital, Tenri, Japan.
Aya ToyofukuDepartment of Obstetrics and Gynecology, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan.
Taito MiyamotoDepartment of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, 54 Kawahara-Cho, Shogoin, Sakyo-Ku, Kyoto-Shi, Kyoto, Japan.
Rin MizunoDepartment of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, 54 Kawahara-Cho, Shogoin, Sakyo-Ku, Kyoto-Shi, Kyoto, Japan.
Mana TakiDepartment of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, 54 Kawahara-Cho, Shogoin, Sakyo-Ku, Kyoto-Shi, Kyoto, Japan.
Ryusuke MurakamiDepartment of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, 54 Kawahara-Cho, Shogoin, Sakyo-Ku, Kyoto-Shi, Kyoto, Japan.
Satoshi MoritaDepartment of Biomedical Statistics and Bioinformatics, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Manabu MutoDepartment of Medical Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Masaki MandaiDepartment of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, 54 Kawahara-Cho, Shogoin, Sakyo-Ku, Kyoto-Shi, Kyoto, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCervical cancer remains a major health problem, and HPV-independent subtypes such as gastric-type adenocarcinoma carry dismal outcomes. Although immune checkpoint inhibitors (ICIs) have improved survival in large trials, their real-world effectiveness including HPV-independent tumors is not well established.

methodsWe conducted a retrospective multicenter study of two surrogate cohorts representing refractory cervical cancer: patients treated with bevacizumab (Bev-cohort, n = 65) and those undergoing comprehensive genomic profiling (CGP-cohort, n = 42). Early ICI administration was evaluated using landmark analysis (Bev: 180 days; CGP: 6 months), with differences in restricted mean survival time (ΔRMST) as the primary endpoint. Multivariable Cox models adjusting for stage, histology, and treatment interval were performed as secondary analyses. Exploratory analyses assessed HPV and molecular status for associations with ICI response.

resultsIn the Bev-cohort, 14 ICI-treated patients achieved significantly longer survival than 48 non-ICI patients (ΔRMST + 19.4 days at 180 days; + 56.2 days at 360 days). Multivariable Cox confirmed ICI as an independent predictor of survival (HR 0.15, 95%CI 0.01-0.69). In the CGP-cohort, 11 ICI-treated patients also experienced superior survival compared with 20 non-ICI patients (ΔRMST + 1.05 months at 6 months; + 2.33 months at 12 months). Among 36 ICI-treated cases overall, efficacy was not clearly associated with PD-L1 or tumor mutation burden status. Importantly, HPV-independent tumors, including gastric-type adenocarcinoma, demonstrated progression-free survival comparable to HPV-associated tumors.

conclusionICIs improved survival in advanced refractory cervical cancer across two real-world cohorts. HPVI may respond favorably, but further studies are needed.

Indexed as

Immune Checkpoint InhibitorsPapillomavirus InfectionsUterine Cervical NeoplasmsAdultAgedBevacizumabFemaleHumansMiddle AgedPapillomaviridaeRetrospective StudiesBevacizumabImmune Checkpoint InhibitorsCervical cancerGastric-type adenocarcinomaHPV-independent tumorsImmune checkpoint inhibitorsPD-L1Tumor mutation burden

Identifiers

PMID41296221

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.