title: Update on immune checkpoint inhibitors in gynecological cancers.
abstract: In recent years, progress in our understanding of immune-modulatory signaling pathways in immune cells and the tumor microenvironment (TME) has led to rejuvenated interest in cancer immunotherapy. In particular, immunotherapy targeting the immune checkpoint receptors such as cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4), programmed cell-death 1 (PD-1), and programmed cell-death ligand 1 (PD-L1) have demonstrated clinical activity in a wide variety of tumors, including gynecological cancers. This review will focus on the emerging clinical data on the therapeutic role of immune checkpoint inhibitors, and potential strategies to enhance the efficacy of this class of compounds, in the context of gynecological cancers. It is anticipated that future biomarker-directed clinical trials will provide further insights into the mechanisms underlying response and resistance to immunotherapy, and help guide our approach to designing therapeutic combinations that have the potential to enhance the benefit of immunotherapy in patients with gynecologic cancers.
authors.affiliation: Department of Hematology-Oncology, National University Hospital, Singapore, Singapore.|Cancer Science Institute of Singapore, National University of Singapore, Singapore, Singapore.
authors.forename: Valerie
authors.identifier: http://orcid.org/0000-0001-8894-1355
authors.initials: V
authors.lastname: Heong
authors.affiliation: Department of Hematology-Oncology, National University Hospital, Singapore, Singapore.
authors.forename: Natalie
authors.identifier: http://orcid.org/0000-0003-2071-0715
authors.initials: N
authors.lastname: Ngoi
authors.affiliation: Department of Hematology-Oncology, National University Hospital, Singapore, Singapore.|Cancer Science Institute of Singapore, National University of Singapore, Singapore, Singapore. david_sp_tan@nuhs.edu.sg.
authors.forename: David Shao Peng
authors.identifier: http://orcid.org/0000-0001-9087-5262
authors.initials: DS
authors.lastname: Tan
mesh_terms: D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D060890:B7-H1 Antigen / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000032:analysis; D060908:CTLA-4 Antigen / Q000627:therapeutic use*; D005260:Female; D005833:Genital Neoplasms, Female / Q000276:immunology*; D006801:Humans; D007167:Immunotherapy; D059016:Tumor Microenvironment / Q000276:immunology*; D014612:Vaccines / Q000627:therapeutic use
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D060890:B7-H1 Antigen; D014408:Biomarkers, Tumor; C423236:CD274 protein, human; D060908:CTLA-4 Antigen; D014612:Vaccines
keywords: Biomarkers; Immunotherapy; Neoplasms; Tumor Microenvironment