Recurrent Cervical Carcinoma Research Articles

The efficacy and safety of cadonilimab after first anti-PD-1 failure in the treatment of recurrent endometrial and cervical carcinoma: A retrospective, real-world study

The efficacy and safety of cadonilimab after first anti-PD-1 failure in the treatment of recurrent endometrial and cervical carcinoma: A retrospective, real-world study

Phase 2 study of the antitumour activity and safety of simlukafusp alfa (FAP-IL2v) combined with atezolizumab in patients with recurrent and/or metastatic cervical squamous cell carcinoma

Simlukafusp alfa (FAP-IL2v) is an immune cytokine engineered to selectively promote immune responses in the tumour microenvironment. We evaluated the antitumour activity and safety of FAP-IL2v plus atezolizumab in recurrent and/or metastatic cervical squamous cell carcinoma (SCC) in a phase 2 basket study (NCT03386721). Patients with confirmed metastatic, persistent or recurrent cervical SCC who had progressed on ≥1 anti-cancer therapy and had measurable disease were enrolled. FAP-IL2v 10mg was administered once every 3 weeks (Q3W) or once weekly (QW) for 4 weeks then once every 2 weeks (Q2W) with the corresponding Q3W or Q2W atezolizumab regimens. The primary endpoint was objective response rate by investigator assessment. Forty-eight patients were enrolled (Q3W: n=47; QW/Q2W: n=1). Among 45 response evaluable patients, objective responses occurred in 12 patients (27%; CI 16.0-41.0), including 3 complete and 9 partial responses. Responses occurred in 6/19 PD-L1 positive patients (32%; 95% CI 15.4-54.0) and 5/24 PD-L1 negative patients (21%; 95% CI 9.2-35.6). Median duration of response was 13.3 months (95% CI 7.6-NE). Median progression-free survival was 3.7 months (95% CI 3.3-9.0). Adverse events (AEs) were consistent with the known safety profile of each drug. AEs leading to withdrawal of either agent occurred in 6 patients (13%). Pronounced expansion and activation of natural killer and CD8 T cells in peripheral blood and increased tumour infiltration and inflammation were observed. FAP-IL2v plus atezolizumab is clinically active and has manageable safety in patients with recurrent and/or metastatic cervical SCC. F. Hoffmann-La Roche Ltd.

Combining Mitomycin C with inhibition of BAD phosphorylation enhances apoptotic cell death in advanced cervical cancer

ObjectiveMitomycin C (MMC), a DNA-damaging chemotherapeutic, is commonly used clinically for recurrent cervical carcinoma (CC), either alone or in combination. MMC generates DNA damage resulting in CC cell death yet also induces increased AKT-BAD phosphorylation associated with drug resistance and reduced clinical benefit. The present study evaluates the efficacy of combined MMC and a BAD phosphorylation inhibitor in CC. MethodsThe association and function of phosphorylation of BAD on serine 99 (pBADS99) for cell survival of both MMC-resistant or sensitive-CC cells was explored. BAD was mutated to BADS99A to examine the requirement of BADS99 for CC cell survival and a novel small-molecule inhibitor of pBADS99 was utilized. Cell proliferation, survival, foci formation, and patient-derived organoids (PDOs) assays were utilized to determine efficacy, synergy and related mechanisms. ResultsMMC IC50 was positively correlated to the cell line pBADS99/BAD ratio. Increased BADS99 phosphorylation was observed in both MMC-sensitive or -resistant CC cells after MMC treatment. Inhibition of pBADS99 in CC cell lines produced synergistic apoptosis through BAD-mediated apoptotic pathways and enhanced DNA damage in response to MMC. The concurrent use of pharmacological inhibition of pBADS99 and MMC was synergistic, resulting in diminished cell viability and inducing apoptotic cell death in MMC-sensitive and -resistant CC cell lines or patient-derived organoids. ConclusionA combination of MMC with inhibition of BAD phosphorylation potentiated efficacy compared to single agent treatment. The potential further development of such strategies may provide outcome benefits to patients with CC.

Salvage radiotherapy for locally recurrent cervical and endometrial carcinoma: clinical outcomes and toxicities

BackgroundThe management of locally recurrent gynecological carcinoma remains a challenge due to the limited availability of data. This study aims to share our institutional experience in using definitive radiotherapy (RT) for the treatment of locally recurrent cervical and endometrial carcinoma.MethodsThe study retrospectively reviewed 20 patients in our hospital completing salvage 3D image-based HDR brachytherapy, with or without EBRT, for locally recurrent cervical and endometrial carcinoma after surgery. The Kaplan–Meier method was applied to estimate the disease-free survival (DFS) and overall survival (OS). The toxicities were assessed by CTCAEv5.ResultsDuring a median observation period of 21 months, the study reported a tumor objective response rate of 95%. The 3-year DFS and OS rates were 89.4% and 90.9%, respectively. The EBRT combined with brachytherapy achieved a median cumulative dose of 88 Gy to CTV D90. 14 patients received concurrent and/or systemic chemotherapy. Two patients suffered locoregional recurrence after salvage treatment, one of whom only received salvage brachytherapy for prior RT history. The analysis identified significant predictors for DFS, including tumor histology and FIGO stage. 5 patients observed acute grade 1–2 rectal (15%) or genitourinary (10%) toxicities. Late toxicities including grade 1–2 rectal bleeding (10%) and grade 2 pelvic fracture (5%) were seen in 3 patients.Conclusions3D image-guided brachytherapy combined with EBRT shows effective tumor control and acceptable toxicity profile for women with locally recurrent gynecologic cancer. The success in managing vaginal recurrence is notably influenced by histologic subtype and FIGO staging.

PO17: The Relationship Between Dose Parameter and Curative Effect on Recurrent Cervical Squamous Cell Carcinoma Treated by 125I Seed

PO17: The Relationship Between Dose Parameter and Curative Effect on Recurrent Cervical Squamous Cell Carcinoma Treated by 125I Seed

Outcomes of DIEP flap reconstruction after pelvic cancer surgery: A retrospective multicenter case series

Flap reconstruction is often required after pelvic tumor resection to reduce wound complications. The use of perforator flaps has been shown to reduce donor site morbidity. The purpose of this study was to evaluate the outcomes of pedicled deep inferior epigastric perforator (pDIEP) flap reconstruction. This was a retrospective multicenter study of patients who underwent immediate pDIEP flap reconstruction for a pelvic or perineal defect after tumor resection between November 2012 and June 2022. The primary outcome was abdominal donor site morbidity, and the secondary outcome was perineal morbidity. Thirty-four patients (median age, 57.5 years) who underwent pelvic exenteration (n=31), extralevator abdominoperineal excision (n=2), or extended vaginal hysterectomy (n=1) were included. The most common indications were recurrent cervical (n=19) and anal (n=4) squamous cell carcinoma. Twenty-nine patients (85%) had a history of radiotherapy. Only one patient (3%) had major (Clavien-Dindo ≥ III) donor site complications (surgical site infection due to tumor recurrence). Eleven patients (32%) had at least one major recipient site complication (surgical site infection [n=1], total [n=2] or partial [n=1] flap loss, perineal dehiscence [n=2], hematoma [n=1], fistula [n=5]). No incisional or perineal hernias were observed during follow-up. Ninety-day survival was 100%. Pedicled DIEP flap reconstructions performed by experienced surgical teams had good outcomes for perineal or vaginal reconstruction, with low abdominal morbidity, in patients with advanced pelvic malignancies who had undergone median laparotomy. The risks and benefits of this procedure should be carefully evaluated preoperatively using clinical and imaging data.

Final analysis of a randomized phase II/III trial of conventional paclitaxel and carboplatin with or without bevacizumab versus dose-dense paclitaxel and carboplatin with or without bevacizumab, in stage IVB, recurrent, or persistent cervical carcinoma (JCOG1311)

ObjectiveTo assess the efficacy of dose-dense weekly paclitaxel plus carboplatin in metastatic or recurrent cervical carcinoma, we conducted a phase II/III randomized controlled study comparing dose-dense paclitaxel and carboplatin with...

Resveratrol and Cervical Cancer: A New Therapeutic Option.

Globally, cervical cancer is the second most common cancer and the third main cause of death related to cancer in women. The cervical cancer mortality rate is higher in underdeveloped and developing vs. developed countries. Chronic infection with human papilloma virus (HPV) can trigger cervical cancer by an interplay of a variety of pathways and molecules (i.e., inflammatory mediators, oxidative stress and apoptosis), leading to carcinogenesis and cancer progression. Cervical carcinoma is treatable in the early stages, while it progresses to metastasis at advanced stages; however, generally, it is poorly manageable with current treatment options. For future advances in the treatment of metastatic or recurrent cervical cancer carcinoma, the identification of new therapeutic platforms is necessary. A new generation of drugs, herbs and spices may provide novel opportunities for cancer therapy. Among the herb-based components, resveratrol has several beneficial effects given its anticancer activities (e.g., anti-angiogenesis, anti-proliferation, anti-metastatic and pro-apoptotic). Hence, this therapeutic agent may prove to have promising potential if clinically corroborated to possess anticancer efficacy. Here, we summarize the chemopreventive and treatment actions of resveratrol for cervical cancer as well as its mechanism of action.

Real-world Efficacy Data on Anti-Angiogenic Drugs in Recurrent Small Cell Cervical Carcinoma: A Retrospective Study.

Small cell carcinoma of the cervix (SCCC) is rare but extremely aggressive and resistant to current therapies. We herein evaluate the efficacy of bevacizumab, apatinib, and anlotinib in recurrent/metastatic SCCC patients in a real-world setting. Recurrent/metastatic SCCC patients were recruited between January 2013 and July 2020. Baseline characteristics were extracted from medical records, and patients were divided into an anti-angiogenic group and non-anti-angiogenic group. The efficacy of treatments was determined using Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 criteria. Kaplan-Meier analysis was performed for survival analysis. Sixteen patients received anti-angiogenic drugs after tumor recurrence/metastasis; of them, 10 cases received them as first-line treatment, 5 cases as second-line treatment, and 1 case as fourth-line treatment. Another 23 patients received traditional therapies, including surgery, chemotherapy, and radiotherapy. The use of anti-angiogenic drugs in first-line treatment significantly prolonged progression-free survival (PFS) compared to the controls, with a median PFS of 8 months (2-20 months) and 3 months (1-10 months), respectively (P = .025). This trend was also notable in patients who started anti-angiogenic treatment after the second-line recurrence/metastasis. However, there was no benefits for overall survival (OS) in either the 10 first-line cases or all 16 cases (P = .499 and .31, respectively). Both bevacizumab and small molecule drugs (apatinib and anlotinib) presented similar efficacy in SCCC patients. At present, this is the largest cohort study that provides real-world data, showing that anti-angiogenic regimens could significantly prolong PFS in recurrent/metastatic SCCC. Aside from bevacizumab, the novel oral small molecule drugs provide more choices with similar efficacy. These findings warrant further validation in well-designed future studies.

Risks and treatment for recurrent intraepithelial cervical lesions

Background. Persistently high incidence of cervical cancer in Russia and significant number of cases detected in the late stages necessitate the improvement of secondary prophylaxis of this disorder.Aim. To assess risk factors for recurrent high-grade cervical intraepithelial neoplasia (CIN2+) (high grade squamous intraepithelial lesions, HSIL) after cervical conization.Materials and methods. This study included 62 patients with recurrent HSIL treated in Novosibirsk Regional Clinical Oncology Dispensary, E. N. Meshalkin National Medical Research Center, “Zdorovye” LLC, “Avismed” LLC, Tomsk National Research Medical Center of the Russian Academy of Sciences, and Federal Research and Clinical Center for Specialized Medical Care and Medical Technologies, Federal Biomedical Agency of the Russian Federation in 2017–2021. We analyzed patients’ human papillomavirus (HPV) status, performed repeated examination of excised tissue specimens to evaluate the severity of lesions and resection margins, as well as immunohistochemical examinations. We found that mean time to cytologically confirmed recurrent HSIL was 16.0 ± 5.6 months. All patients were HPV-positive. Repeated histological examination demonstrated that 18 samples had positive resection margins or endocervical crypt involv ement. Fifty-seven samples had positive staining for p16 at immunohistochemical examination; 46 samples had Ki-67 >30 %, which indicated high risk of recurrence. Treatment of patients with recurrent HSIL included repeated excision up to healthy cervical tissues, followed by intravaginal therapy with Cervicon-DIM 100 mg twice a day (for 3 months). Follow-up examinations after 18.0 ± 6.2 months on average showed no HPV persistence and no HSIL recurrence.Conclusion. Endocervical crypt involvement along the primary resection margin, underestimated severity and depth of lesions (at the first surgery), and persistence of HPV infection are the main risk factors for recurrent cervical dysplasia or carcinoma in situ. Combination treatment that includes additional excision with a subsequent course of Cervicon-DIM is sufficient and effective.

Life-threatening bleeding after pelvic exenteration for recurrent cervical cancer: endovascular management of ruptured external iliac artery pseudoaneurysm: a case report and literature review

Background: Clinically, postoperative pseudoaneurysm rupture following gynecological radical surgeries is a very rare but fatal complication. The occurrence of this fatal complication should arouse the concern of clinicians. Accurate diagnosis and immediate treatment is needed for this emergency condition. Case: A 56-year-old women had life-threatening bleeding caused by ruptured external iliac artery pseudoaneurysm five months after pelvic exenteration for recurrent cervical squamous carcinoma. Emergency left external iliac artery covered stent placement was successfully performed to control the massive bleeding. The patient recovered well and no complication was observed during a three month follow-up period. Conclusions: In some cases, endovascular techniques may be an attractive alternative.

FDG PET-CT as an important diagnostic tool and prognostic marker in suspected recurrent cervical carcinoma after radiotherapy: comparison with MRI.

Recurrent disease in post-irradiation patients with cervical cancer is often difficult to delineate on magnetic resonance imaging (MRI), because posttreatment changes can have a similar appearance, and further evaluation is often required. The aims of the study were to evaluate positron emission tomography/computed tomography with 18F-fluorodeoxyglucose (FDG PET-CT) diagnostic role in suspected recurrent cervical cancer after radiotherapy, compare it to MRI, and assess their prognostic impact in these patients. This cohort retrospective study included patients previously treated with radiotherapy for carcinoma of uterine cervix with suspected recurrence, who had undergone MRI of abdomen and pelvis, and were subsequently evaluated on FDG PET-CT, with minimum follow-up period of 12 months. In the total of 84 patients included in analysis, MRI vs. FDG PET-CT showed sensitivity, specificity and accuracy of 80.1%, 52.4% and 66.7%, vs. 97.6%, 61.9% and 79.8%, respectively. Patients with positive findings on MRI (Log Rank, p = 0.003) and PET-CT (Log Rank, p < 0.001) had shorter progression-free survival (PFS) than those with negative results. In univariate Cox regression models, MRI and FDG PET-CT results were found to be related to PFS (p = 0.005 and p < 0.001, respectively). However, multivariate analysis proved only FDG PET-CT to be independent prognostic factor, where patients with positive FDG PET-CT results had almost nine times higher risk of progression (p < 0.001). FDG PET-CT represents useful diagnostic tool in suspected recurrent cervical cancer after radiotherapy, showing high sensitivity in its detection. In addition, it is an independent factor in predicting progression-free survival in these patients.

RIGHT-SIDED CHYLOTHORAX DUE TO RECURRENT CERVICAL CANCER WITH PLEURAL METASTASIS

RIGHT-SIDED CHYLOTHORAX DUE TO RECURRENT CERVICAL CANCER WITH PLEURAL METASTASIS

295. BILATERAL VOCAL CORD PARALYSIS AFTER HYPOPHARYNGEAL CERVICAL ESOPHAGEAL ESD—AN UNRECOGNISED RARE COMPLICATION

Abstract This is a video showing ESD performed for recurrent early cervical esophageal squamous cell carcinoma in close proximity to the pharynx. The procedure was completed smoothly with en-bloc resection. However, patient developed vocal cord paralysis requiring temporary tracheostomy. It is postulated that vocal cord paralysis was caused by posterior cricoarytenoid muscle injury. This important muscle is the only laryngeal muscle that opens the vocal folds, and will lead to potential airway compromise if injured. There hasn’t been any report of vocal cord paralysis after cervical esophageal ESD, and this case illustrates that this potentially lethal complication should not be overlooked.

Pembrolizumab, radiotherapy, and an immunomodulatory five-drug cocktail in pretreated patients with persistent, recurrent, or metastatic cervical or endometrial carcinoma: Results of the phase II PRIMMO study

A phase II study (PRIMMO) of patients with pretreated persistent/recurrent/metastatic cervical or endometrial cancer is presented. Patients received an immunomodulatory five-drug cocktail (IDC) consisting of low-dose cyclophosphamide, aspirin, lansoprazole, vitamin D, and curcumin starting 2 weeks before radioimmunotherapy. Pembrolizumab was administered three-weekly from day 15 onwards; one of the tumor lesions was irradiated (8Gyx3) on days 15, 17, and 19. The primary endpoint was the objective response rate per immune-related response criteria (irORR) at week 26 (a lower bound of the 90% confidence interval [CI] of > 10% was considered efficacious). The prespecified 43 patients (cervical, n = 18; endometrial, n = 25) were enrolled. The irORR was 11.1% (90% CI 2.0–31.0) in cervical cancer and 12.0% (90% CI 3.4–28.2) in endometrial cancer. Median duration of response was not reached in both cohorts. Median interval-censored progression-free survival was 4.1 weeks (95% CI 4.1–25.7) in cervical cancer and 3.6 weeks (95% CI 3.6–15.4) in endometrial cancer; median overall survival was 39.6 weeks (95% CI 15.0–67.0) and 37.4 weeks (95% CI 19.0–50.3), respectively. Grade ≥ 3 treatment-related adverse events were reported in 10 (55.6%) cervical cancer patients and 9 (36.0%) endometrial cancer patients. Health-related quality of life was generally stable over time. Responders had a significantly higher proportion of peripheral T cells when compared to nonresponders (p = 0.013). In conclusion, PRIMMO did not meet its primary objective in both cohorts; pembrolizumab, radiotherapy, and an IDC had modest but durable antitumor activity with acceptable but not negligible toxicity.Trial registration ClinicalTrials.gov (identifier NCT03192059) and EudraCT Registry (number 2016-001569-97).

Pembrolizumab in pretreated advanced, metastatic cervical, vulvar, vaginal carcinoma (325)

<b>Objectives:</b> Recurrent, pretreated cervical carcinoma is a notoriously difficult-to-treat disease with a poor prognosis. Pembrolizumab was granted accelerated approval by the FDA in June 2018 in the setting of pretreated, recurrent, or metastatic cervical cancer based on preliminary results of the phase II basket trial KEYNOTE-158. While the reported objective response rate was only 12%, many patients exhibited a durable response, with some remaining on treatment for >12 months. We sought to examine the real-world incorporation and utilization of this treatment option and evaluate patient outcomes in an academic and safety-net county hospital system. <b>Methods:</b> Based upon timing of accelerated FDA approval and to allow for lead-in, review of institutional data identified women with pretreated recurrent, persistent, or metastatic cervical, vaginal, or vulvar carcinoma who were planned to receive pembrolizumab from 2017 to 2021. Demographics and clinical-pathologic data were collected. Duration of treatment, treatment-related adverse events, and clinical outcomes were analyzed. Patients with uterine and ovarian primary tumors, PD-L1 negative status, and those who did not receive a single cycle of treatment were excluded. <b>Results:</b> Fifty-two patients were identified, of whom 20 were included in the analysis. The median number of prior systemic lines of treatment was 1 (max 4). The objective response rate was 11.7%, with a clinical benefit rate of 47%. Overall, the median duration of treatment (mDOT) was 2.1 months (two cycles, IQR: 1-8). Among patients with progression of disease or death, mDOT was 2.1 months (two cycles, IQR: 2-3). Twenty-five percent of patients received at least ten cycles, all of whom presently remain on treatment (mDOT 13 months). Treatment was generally well-tolerated, with 25% experiencing any toxicity (majority G2 hypothyroidism). One patient suffered grade 3+ toxicity - immune-mediated colitis, which resulted in cessation of treatment after one cycle. The most common reasons for non-initiation of treatment with pembrolizumab included a loss to follow-up, PD-L1 negative tumors, or enrollment in clinical trials. <b>Conclusions:</b> Pembrolizumab is generally well-tolerated in the treatment of recurrent cervical cancer, and real-world experience is compared favorably with published clinical trial outcomes data. One- quarter of patients experienced a durable response of > 10 months with minimal toxicity.

9P A prospective study of gefitinib in patients with recurrent or metastatic cervical cancer

Cervical cancer is the fourth most common cancers among women worldwide. Although the cure rates in early-stage disease are good, 30% to 40% of patients in advanced-stage disease ultimately develop locoregional or distal recurrence or both. The prognosis of recurrent cervical carcinoma is very poor, and treatment of such patients remains a challenge. Because of the limited success and significant toxicity with cytotoxic chemotherapy drugs in such subset of patients, interest has grown in EGFR targeted therapeutics.

Camrelizumab for the treatment of advanced cervical adenocarcinoma: a case report and literature review

Cervical adenocarcinoma belongs to an invasive subtype of cervical carcinoma, presenting poorly prognostic status. Chemotherapy treatment for recurrent cervical carcinoma are thought to be limited and supposed to be noncurative. Because of the poor prognosis of patients with recurrent cervical carcinoma, however, the benefits of second-line chemotherapy have not yet reached a consensus. Immunotherapy is a split-new tactic of overwhelming carcinomas that relies on the instinct of the immune system to recognize and directly kill neoplasm cells. Here, we reported a 55-year-old female patient with clinical stage IVB cervical adenocarcinoma. The patient received four cycles of systematic therapy, with the regimen of docetaxel plus carboplatin in combined with bevacizumab anti-vascular therapy. The progressive disease (PD) was assessed by imaging evaluation and PD was confirmed once more after four cycles of chemotherapy of albumin paclitaxel plus cisplatin. The patient exhibited a good response during the twelve-cycle of immunotherapy of Camrelizumab, whereas PD was observed upon termination of her immunotherapy. This case with the treatment of PD-1 inhibitor Camrelizumab exhibits a good curative effect and tolerable adverse reactions. In addition, some clinical markers and biomarkers expression levels can be served as the predictors of the effect of anti-PD-1 immunotherapy.

Image Navigation Surgery With the Fluorescent Ureteral Catheter of Recurrent Tumors in the Pelvic Cavity.

Ureteral injury during pelvic surgery is a serious complication that requires special attention. The fluorescent ureteral catheter near-infrared ray catheter sets are 6.0F catheters containing fluorescent substances along their length that can be recognized by a laparoscopic indocyanine green camera. We present our experience using a near-infrared ray catheter in 6 consecutive patients who underwent surgery for recurrent pelvic tumors. The near-infrared ray catheters were inserted into the bilateral ureters in all patients, with the exception of patient 5 (left unilateral), by urologists using a cystoscope with the same technique as that commonly used in placing ureteral stents under general anesthesia. A laparoscopic indocyanine green camera was adapted to identify the ureters. From February 2020 to July 2020, 6 consecutive patients with recurrent pelvic tumors underwent surgery using a near-infrared ray catheter. In 3 patients, recurrent tumors were detected in the pelvic cavity after surgery for colon cancer (1 patient each of peritoneal recurrence behind the seminal vesicles, lymph node metastasis on the residual superior rectal artery, and peritoneal recurrence at the peritoneal reflection). Two patients had postoperative local recurrences of rectal cancer. The last patient had a recurrence of cervical carcinoma invading the rectum. All patients underwent surgery under ureteral image navigation using near-infrared ray catheter not only for ureter preservation during the operation (4 patients) but also for the combined resection of the ureter with recurrent tumors (2 patients). One patient experienced postoperative ureteral stenosis on postoperative day 21 that required a ureteral double J-stent placement in the left ureter. Near-infrared ray catheter has the potential to reduce inadvertent periureteral dissection because the ureter can be identified before approaching it.

Pemetrexed-cisplatin combined with antiangiogenesis drug in recurrent and metastatic cervical carcinoma: A case report and literature review

Pemetrexed is an antifolate agent which has shown activity on various tumors. But no result has been reported on the clinical efficacy and toxicity of pemetrexed combined with antiangiogenesis drug in patients with cervical cancer. Apatinib is an oral antiangiogenesis drug in cervical cancer, which has been reported efficacy and safety in cervical cancer. Here, we present a 50-year-old woman who was diagnosed with recurrent and metastatic cervical adenocarcinoma two years after postoperative adjuvant radiotherapy. After pathology and magnetic resonance imaging confirmed the recurrence and metastasis, the patient was administered pemetrexed 500 mg/m2 and cisplatin 50 mg/m2 on day 1, cycled every three weeks for four cycles. Then add apatinib 500 mg/d from day 1 to day 21 combined with pemetrexed and cisplatin for two cycles, followed by pemetrexed 500 mg/m2 on day 1 combined with apatinib every 21 days per cycle for two cycles. Finally, a single dose of apatinib is a maintenance therapy. According to the Response Evaluation Criteria In Solid Tumors (RECIST) 1.1 standard, she was confirmed as Partial Response (PR). Now, the Progression-Free Survival (PFS) of the patient has been 21 months. No grade III-IV adverse effects have been found. In conclusion, pemetrexed-cisplatin combined with antiangiogenesis drug might be an effective and mild toxic treatment for patients with recurrent or metastatic cervical carcinoma. Further prospective clinical trials are needed to verify this conclusion.