Abstract

Simple SummaryGynecological cancers represent a group of malignancies with high incidence and mortality, despite their relative sensitivity to platinum-based chemotherapy. This review aims to illustrate the state of research in the field of immunotherapy, and in particular, deals with the development of CAR-T cell therapy, which represents a very promising treatment in the hematological field, but is still taking its first tentative steps in solid tumors.Gynecological tumors are malignancies with both high morbidity and mortality. To date, only a few chemotherapeutic agents have shown efficacy against these cancer types (only ovarian cancer responds to several agents, especially platinum-based combinations). Within this context, the discovery of immune checkpoint inhibitors has led to numerous clinical studies being carried out that have also demonstrated their activity in these cancer types. More recently, following the development of chimeric antigen receptor (CAR)-T cell therapy in hematological malignancies, this strategy was also tested in solid tumors, including gynecological cancers. In this article, we focus on the molecular basis of gynecological tumors that makes them potential candidates for immunotherapy. We also provide an overview of the main immunotherapy studies divided by tumor type and report on CAR technology and the studies currently underway in the area of gynecological malignancies.

Highlights

  • We provide an overview of the main immunotherapy studies divided according to tumor type, and report on chimeric antigen receptor (CAR) technology and the studies currently underway in the area of gynecological cancers

  • The poor results may be related to the rate of other toxicities, namely, prolonged lymphopenia, infections, cytokine release syndrome (CRS) and neurotoxicity, all of which are frequent with the CAR-T cell treatment

  • As seen for other cancer types, the road to using this therapy in solid tumors is much more complex than in hematological malignancies and must overcome various obstacles, the most important being the negative influence of the tumor microenvironment

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Summary

Introduction

2018 [1], cervical cancer (CC) is the fourth most commonly diagnosed tumor and the fourth cause of cancer death in females, worldwide, but ranks second in both incidence and mortality in lower income countries. With an estimated 295,414 cases and 184,799 deaths in. 2018 worldwide, ovarian cancer (OC) represents 1.6% of all cancer incidence and 1.3% of all cancer deaths. With regard to endometrial cancer (EC), 382,069 new cases and 89,929 deaths were reported globally in 2018, representing 2.1% of all new cancer cases and 0.9% of all cancer deaths [1]. Gynecological cancers do not substantially benefit from classic chemotherapy regimens

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