MOLECULAR MECHANISMS AND CLINICAL EFFICACY OF IMMUNOTHERAPY IN CERVICAL CANCER: A SYSTEMATIC REVIEW FROM THE PERSPECTIVE OF NEOADJUVANT USE IN STAGE II DISEASE

This article systematizes the molecular and biological mechanisms of tumor immune evasion in cervical cancer associated with high-risk human papillomavirus (HPV) infection and provides a comprehensive review of clinical evi­dence regarding the use of various classes of immunotherapeutic agents. Particular attention is paid to the rationale for their application in the neoadjuvant setting for stage II cervical cancer (T2a,b N0,1). The results of key clinical trials, including KEYNOTE-158, KEYNOTE-028, CheckMate 358, GOG 9929, and GOG 0265, are reviewed. The prognostic significance of PD-L1 expression, the density of tumor-infiltrating lymphocytes (TILs), and the synergistic effects of immunotherapy combined with radiotherapy are also analyzed. Summary tables of clinical outcomes and a schematic representation of immunopathological mechanisms are presented.