Resumen
Introducción: La inmunoterapia celular es una estrategia terapéutica que emplea el sistema inmunitario para combatir el cáncer y ha mostrado resultados favorables en diversos tipos de tumores. Objetivos: Este trabajo evaluó la evidencia sobre Terapias Celulares Adoptivas (TCA) que han sido usadas en el tratamiento de mujeres con cáncer de cuello uterino. Metodología: Se incluyeron estudios que evaluaron TCA en cualquier fase del cáncer de cuello uterino, excluyendo aquellos con un solo paciente. Se realizó una búsqueda en bases de datos como PubMed, Web of Science, Scopus y Google Scholar, empleando Rayyan para la revisión sistemática y Zotero para la gestión de referencias. Resultados: El análisis incluyó tres estudios en países de altos ingresos sobre TCA combinada con quimiorradioterapia. Dos abordaron linfocitos infiltrantes de tumor (LIT) y uno la infusión de Células asesinas naturales inducidas por citocinas CIK (del inglés, cytokine-induced killer cells). Todos fueron ensayos clínicos en fase I y II. Conclusiones: Las TCA muestran potencial como tratamiento complementario, pero se requieren estudios adicionales para evaluar su eficacia y seguridad.
Citas
1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021; 71(3): 209–49. doi: https://doi.org/10.3322/caac.21660
2. Ferlay J, Colombet M, Soerjomataram I, Parkin DM, Piñeros M, Znaor A, et al. Cancer statistics for the year 2020: An overview. Int J Cancer. 2021; 149(4): 778-89. doi: https://doi.org/10.1002/ijc.33588
3. Giannella L, Delli Carpini G, Di Giuseppe J, Grelloni C, Bogani G, Dri M, et al. Long-Term Follow-Up Outcomes in Women with In Situ/Microinvasive Adenocarcinoma of the Uterine Cervix Undergoing Conservative Treatment—Cervical Adenocarcinoma Study Group Italian Society of Colposcopy and Cervico-Vaginal Pathology. Cancers (Basel). 2024; 16(6): 1241. doi: https://doi.org/10.3390/cancers16061241
4. Son J, George GC, Nardo M, Krause KJ, Jazaeri AA, Biter AB, et al. Adoptive cell therapy in gynecologic cancers: A systematic review and meta-analysis. Gynecol Oncol. 2022; 165(3): 664-70. doi: https://doi.org/10.1016/j.ygyno.2022.03.013
5. Li CR, Greenberg PD, Gilbert MJ, Goodrich JM, Riddell SR. Recovery of HLA-restricted cytomegalovirus (CMV)-specific T-cell responses after allogeneic bone marrow transplant: correlation with CMV disease and effect of ganciclovir prophylaxis. Blood. 1994; 83(7): 1971-9. doi: https://doi.org/10.1182/blood.V83.7.1971.1971
6. Yee C, Thompson JA, Byrd D, Riddell SR, Roche P, Celis E, et al. Adoptive T cell therapy using antigen-specific CD8+ T cell clones for the treatment of patients with metastatic melanoma: in vivo persistence, migration, and antitumor effect of transferred T cells. Proc Natl Acad Sci USA. 2002; 99(25): 16168-73. doi: https://doi.org/10.1073/pnas.242600099
7. Smyth MJ, Swann J, Cretney E, Zerafa N, Yokoyama WM, Hayakawa Y. NKG2D function protects the host from tumor initiation. J Exp Med. 2005; 202(5): 583-8. doi: https://doi.org/10.1084/jem.20050994
8. Kaech SM, Tan JT, Wherry EJ, Konieczny BT, Surh CD, Ahmed R. Selective expression of the interleukin 7 receptor identifies effector CD8 T cells that give rise to long-lived memory cells. Nat Immunol. 2003; 4(12): 1191-8. doi: https://doi.org/10.1038/ni1009
9. Adusumilli PS, Cherkassky L, Villena-Vargas J, Colovos C, Servais E, Plotkin J, et al. Regional delivery of mesothelin-targeted CAR T cell therapy generates potent and long-lasting CD4-dependent tumor immunity. Sci Transl Med. 2014; 6(261): 261ra151. doi: https://doi.org/10.1126/scitranslmed.3010162
10. Dunn GP, Old LJ, Schreiber RD. The three Es of cancer immunoediting. Annu Rev Immunol. 2004; 22: 329-60. doi: https://doi.org/10.1146/annurev.immunol.22.012703.104803
11. Peters MD, Godfrey C, McInerney P, Munn Z, Tricco AC, Khalil H. Chapter 11: Scoping Reviews. JBI Manual for Evidence Synthesis. 2020. doi: https://doi.org/10.46658/JBIMES-24-09
12. Tricco AC, Lillie E, Zarin W, O'Brien KK, Colquhoun H, Levac D, et al. PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med. 2018; 169(7): 467-73. doi: https://doi.org/10.7326/M18-0850
13. Huang H, Nie CP, Liu XF, Song B, Yue JH, Xu JX, et al. Phase I study of adjuvant immunotherapy with autologous tumor-infiltrating lymphocytes in locally advanced cervical cancer. J Clin Invest. 2022; 132(15): e151939. doi: https://doi.org/10.1172/JCI157726
14. Stevanović S, Draper LM, Langhan MM, Campbell TE, Kwong ML, Wunderlich JR, et al. Complete regression of metastatic cervical cancer after treatment with human papillomavirus–targeted tumor-infiltrating T cells. J Clin Oncol. 2015; 33(14): 1543-50. doi: https://doi.org/10.1200/JCO.2014.58.9093
15. Rutella S, Iudicone P, Bonanno G, Fioravanti D, Procoli A, Lavorino C, et al. Adoptive immunotherapy with cytokine-induced killer cells generated with a new good manufacturing practice-grade protocol. Cytotherapy. 2012; 14(7): 841-50. doi: https://doi.org/10.3109/14653249.2012.68103
16. Li N, Tian YW, Xu Y, Meng DD, Gao L, Shen WJ, et al. Combined treatment with autologous CIK cells, radiotherapy and chemotherapy in advanced cervical cancer. Pathology & Oncology Research. 2019; 25(2): 691-6. https://doi.org/10.1007/s12253-018-0541-2
17. Hinrichs CS, Rosenberg SA. Exploiting the curative potential of adoptive T‐cell therapy for cancer. Immunol Rev. 2014; 257(1): 56-71. doi: https://doi.org/10.1111/imr.12132
18. Hinrichs CS, Restifo NP. Reassessing target antigens for adoptive T-cell therapy. Nat Biotechnol. 2013; 31(11): 999-1008. doi: https://doi.org/10.1038/nbt.2725
19. Moody CA, Laimins LA. Human papillomavirus oncoproteins: pathways to transformation. Nat Rev Cancer. 2010; 10(8): 550-60. doi: https://doi.org/10.1038/nrc2886
20. Liang X, Hu X, Hu Y, Zeng W, Zeng G, Ren Y, et al. Recovery and functionality of cryopreserved peripheral blood mononuclear cells using five different xeno-free cryoprotective solutions. Cryobiology. 2019; 86: 25-32. doi: https://doi.org/10.1016/j.cryobiol.2019.01.004
21. Thorne SH, Negrin RS, Contag CH. Synergistic antitumor effects of immune cell-viral biotherapy. Science. 2006; 311(5768): 1780-4. doi: https://doi.org/10.1126/science.1121411
22. Groh V, Wu J, Yee C, Spies T. Tumour-derived soluble MIC ligands impair expression of NKG2D and T-cell activation. Nature. 2002; 419(6908): 734-8. doi: https://doi.org/10.1038/nature01112
23. Ramondetta L. What is the appropriate approach to treating women with incurable cervical cancer? J Natl Compr Canc Netw. 2013; 11(3): 348-55. doi: https://doi.org/10.6004/jnccn.2013.0044
24. Tewari KS, Sill MW, Long HJ 3rd, Penson RT, Huang H, Ramondetta LM, et al. Improved survival with bevacizumab in advanced cervical cancer. N Engl J Med. 2014; 370(8): 734-43. doi: https://doi.org/10.1056/NEJMoa1309748
25. Monk BJ, Mas Lopez L, Zarba JJ, Oaknin A, Tarpin C, Termrungruanglert W, et al. Phase II, open-label study of pazopanib or lapatinib monotherapy compared with pazopanib plus lapatinib combination therapy in patients with advanced and recurrent cervical cancer. J Clin Oncol. 2010; 28(22): 3562-9. doi: https://doi.org/10.1200/JCO.2009.26.9571
26. Mackay HJ, Tinker A, Winquist E, Thomas G, Swenerton K, Oza A, et al. A phase II study of sunitinib in patients with locally advanced or metastatic cervical carcinoma: NCIC CTG Trial IND.184. Gynecol Oncol. 2010; 116(2): 163-7. doi: https://doi.org/10.1016/j.ygyno.2009.08.012
27. Xu Y, Jiang J, Wang Y, Wang W, Li H, Lai W, et al. Engineered T Cell Therapy for Gynecologic Malignancies: Challenges and Opportunities. Front Immunol. 2021; 12: 725330. doi: https://doi.org/10.3389/fimmu.2021.725330
28. Robbins PF, Lu YC, El-Gamil M, Li YF, Gross C, Gartner J, et al. Mining exomic sequencing data to identify mutated antigens recognized by adoptively transferred tumor-reactive T cells. Nat Med. 2013; 19(6): 747-52. doi: https://doi.org/10.1038/nm.3161
29. Ojesina AI, Lichtenstein L, Freeman SS, Pedamallu CS, Imaz-Rosshandler I, Pugh TJ, et al. Landscape of genomic alterations in cervical carcinomas. Nature. 2014; 506(7488): 371-5. doi: https://doi.org/10.1038/nature12881
30. Wright AA, Howitt BE, Myers AP, Dahlberg SE, Palescandolo E, Van Hummelen P, et al. Oncogenic mutations in cervical cancer: genomic differences between adenocarcinomas and squamous cell carcinomas of the cervix. Cancer. 2013; 119(21): 3776-83. doi: https://doi.org/10.1002/cncr.28288
31. Dudley ME, Wunderlich JR, Yang JC, Sherry RM, Topalian SL, Restifo NP, et al. Adoptive cell transfer therapy following non-myeloablative but lymphodepleting chemotherapy for the treatment of patients with refractory metastatic melanoma. J Clin Oncol. 2005; 23(10): 2346-57. doi: https://doi.org/10.1200/JCO.2005.00.240
32. Reducing Uncertainties About the Effects of Chemoradiotherapy for Cervical Cancer: A Systematic Review and Meta-Analysis of Individual Patient Data From 18 Randomized Trials. J Clin Oncol. 2008; 26(35): 5802-12. doi: https://doi.org/10.1200/JCO.2008.16.436
33. Mordhorst LB, Karlsson L, Bärmark B, Sorbe B. Combined external and intracavitary irradiation in treatment of advanced cervical carcinomas: predictive factors for treatment outcome and early and late radiation reactions. Int J Gynecol Cancer. 2014; 24(7): 1301-8. doi: https://doi.org/10.1097/IGC.0000000000000208
34. Rose PG, Ali S, Whitney CW, Lanciano R, Stehman FB. Outcome of stage IVA cervical cancer patients with disease limited to the pelvis in the era of chemoradiation: a Gynecologic Oncology Group study. Gynecol Oncol. 2011; 121(3): 542-5. doi: https://doi.org/10.1016/j.ygyno.2011.02.024
35. Seitter SJ, Sherry RM, Yang JC, Robbins PF, Shindorf ML, Copeland AR, et al. Impact of prior treatment on the efficacy of adoptive transfer of tumor-infiltrating lymphocytes in patients with metastatic melanoma. Clin Cancer Res. 2021; 27(19): 5289-98. doi: https://doi.org/10.1158/1078-0432.CCR-21-1171
36. Besser MJ, Shapira-Frommer R, Itzhaki O, Treves AJ, Zippel DB, Levy D, et al. Adoptive transfer of tumor-infiltrating lymphocytes in patients with metastatic melanoma: intent-to-treat analysis and efficacy after failure to prior immunotherapies. Clin Cancer Res. 2013; 19(17): 4792-800. doi: https://doi.org/10.1158/1078-0432.CCR-13-0380
37. Andreu-Sanz D, Gregor L, Carlini E, Scarcella D, Marr C, Kobold S. Predictive value of preclinical models for CAR-T cell therapy clinical trials: a systematic review and meta-analysis. Journal for ImmunoTherapy of Cancer. 2025; 13(6): e011698. doi: https://doi.org/10.1136/jitc-2025-011698
38. Turicek DP, Giordani VM, Moraly J, Taylor N, Shah NN. CAR T-cell detection scoping review: an essential biomarker in critical need of standardization. Journal for immunotherapy of cancer. 2023; 11(5): e006596. doi: https://doi.org/10.1136/jitc-2022-006596
39. Bremers AJ, Parmiani G. Immunology and immunotherapy of human cancer: present concepts and clinical developments. Critical reviews in oncology/hematology. 2000; 34(1): 1-25. doi: https://doi.org/10.1016/S1040-8428(99)00059-1
40. Fernández VA, Martínez PB, Granhøj JS, Borch TH, Donia M, Svane IM. Biomarkers for response to TIL therapy: a comprehensive review. Journal for ImmunoTherapy of Cancer. 2024; 12(3): e008640. doi: https://doi.org/10.1136/jitc-2023-008640
41. Giudice E, Mirza MR, Lorusso D. Advances in the management of recurrent cervical cancer: state of the art and future perspectives. Current Oncology Reports. 2023; 11: 1307-26. doi: https://doi.org/10.1007/s11912-023-01463-9

Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.
Derechos de autor 2025 Brian Mauricio Alfonso Díaz, Maicol Andrés Avellaneda Arciniegas, Leidy Johanna Rueda Diaz, Bladimiro Rincón-Orozco
