Immune Checkpoint Inhibition in the Treatment of Gynecologic Cancer

Purpose of Review The purpose of this review is to update readers on recent advancements in the use of immune checkpoint inhibitors for the treatment of ovarian, uterine, and cervical cancers. Recent Findings Immunotherapy has emerged as a novel therapeutic paradigm in the treatment of gynecologic malignancies. Currently, immune checkpoint inhibitors are approved for use across five solid malignancies, with recent approval of pembrolizumab in patients with MMR-deficient, recurrent, solid tumors in a disease site agnostic fashion. Phase 3 clinical trials are being conducted in the gynecologic cancer arena to determine if checkpoint inhibition will improve oncologic outcomes. Positive signals have been identified in ovarian cancer cohorts, both as single agents and in combination with other agents. It is anticipated that immunotherapy will be effective inMMR-deficient endometrial cancers, and trials are in development to explore these agents in the front line. Furthermore, the HPV-driven biology of cervical cancer suggests that immune checkpoint inhibition may lead to clinical benefit. Summary Immune checkpoint inhibitors represent a dynamic and exciting opportunity for patients with limited therapeutic options. We eagerly await the results of ongoing phase 3 clinical trials that will inform practice patterns. In addition, emphasizing translational end-points informing patient selection and response is critical.