Decreasing expression of HIF-1α, VEGF-A, and Ki67 with efficacy of neoadjuvant therapy in locally advanced cervical cancer - Study results

Q: What is the purpose of measuring HIF-1α, VEGF-A, and Ki67 in this study?

The study investigates whether these biomarkers can be effective and predictive for evaluating NACT efficacy in locally advanced cervical cancer.

Q: How were biomarker expressions evaluated in the study?

HIF-1α, VEGF-A, and Ki67 were detected using immunohistochemistry in 42 paired tissues (pre-NACT and post-NACT) and 40 nonneoplastic cervical epithelial tissues.

Q: What did the results show about biomarker expression after NACT?

HIF-1α, VEGF-A, and Ki67 were overexpressed in tumors compared with nonneoplastic tissues, and their expression significantly decreased after NACT.

Q: Which factors were associated with better NACT response?

Lower histological grade and lower expression of HIF-1α, VEGF-A, and Ki67 were associated with improved responsiveness, and histological grade, HIF-1α, and Ki67 were identified as independent risk factors affecting NACT efficacy.

Sep 24, 2026

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Neoadjuvant chemotherapy (NACT) before radical hysterectomy is used for locally advanced cervical cancer, yet its clinical efficacy remains uncertain. This study examined whether biomarker expression can predict and reflect NACT response. HIF-1α, VEGF-A, and Ki67 were assessed in paired pre- and post-NACT tumor tissues and nonneoplastic cervical epithelium. Expression levels decreased after NACT and were associated with better response, with several biomarkers acting as independent risk factors.

LanguageEnglish

CategoryHealthcare

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Pages6

Reading Time15 min

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Abstract

Background

Methods

Results

Conclusion

Introduction

® Clinical Trial/Experimental Study Decreasing expression of HIF-1α, VEGF-A, and Ki67 with efficacy of neoadjuvant therapy in locally advanced cervical cancer Ke Zhao, MDa , Min Hu, MDb , Runfeng Yang, MDa , Jing Liu, MDc , Pingfan Zeng, BDc , Tingkuan Zhao, MDc,* | Abstract
Background: Neoadjuvant chemotherapy (NACT) before radical hysterectomy has been widely used for locally advanced cervical cancer (LACC); However, its efficacy is yet to be determined.
Methods: Effective and predictive biomarkers, which may aid in predicting the chemotherapy responses, were explored in this study. Initially, the expression of HIF-1α , VEGF-A, and Ki67 was detected in 42 paired (pre-NACT and post-NACT) LACC tissues, as well as 40 nonneoplastic cervical epithelial tissues by immunohistochemistry. Then, the correlation of the expression of HIF-1α , VEGF-A, Ki67 with the efficacy of NACT, as well as factors that affect the efficacy of NACT was analyzed.
Results: A clinical response occurred in 66.7%(28/42) of the patients, including 57. 1%(16/28) with a complete response and 42.9%(12/28) with a partial response; While 33.33%(14/42) were non-responders, including 42.9%(6/14) with stable disease and 57. 1%(8/14) with progressive disease. HIF-1α , VEGF-A, and Ki67 were overexpressed in LACC tissues compared to nonneoplastic tissues (P < .01, respectively); While the expression of HIF-1α , VEGF-A, and Ki67 was significantly decreased after NACT (P < .01, respectively) . What’s more, in the response group, HIF-1α , VEGF-A, and Ki67 expression were significantly decreased after chemotherapy in the post-chemotherapy cervical cancer tissues compared with the pre-chemotherapy cervical cancer tissues (all P < .05) . Additionally, patients with lower histological grade and lower expression of HIF-1α , VEGF-A, and Ki67 were more responsive to NACT (P < .05, respectively); Moreover, the histological grade [P = .025, HR (95% CI): 0.133 (0 .023–0.777)], HIF-1α [P = .019, HR (95% CI): 0.599 (0 .390–0.918)], and Ki67 [P = .036, HR (95% CI): 0.946 (0898–0 .996)] were independent risk factors affecting the efficacy of NACT in LACC.
Conclusion: Expression of HIF-1α , VEGF-A, and Ki67 were significantly decreased after NACT, and decreasing expression of HIF-1α , VEGF-A, and Ki67 were related to good response to NACT, suggesting HIF-1α , VEGF-A, and Ki67 may be implicated in evaluating the efficacy of NACT in LACC.
Abbreviations: CR = complete response, FIGO = International Federation of Gynecology and Obstetrics, HIF-1α = hypoxiainducible factor 1α , IHC = immunohistochemical, LACC = locally advanced cervical cancer, NACT = neoadjuvant chemotherapy, PD = progressive disease, PR = partial response, SD = stable disease, VEGF = vascular endothelial growth factor, VEGF-A = vascular endothelial growth factor. | | --- | | Keywords: HIF-1α , Ki67 , locally advanced cervical cancer (LACC) , NACT, VEGF-A | 1. Introduction Cervical cancer remains the 4th most common malignancy diagnosed in women globally, despite the several advances in its screening, prevention, diagnosis, and treatment in recent years. [1] More than half a million women are diagnosed with cervical cancer annually, resulting in over 300,000 deaths, with high incidence and mortality in developing countries.[2] Since the early 1980s, neoadjuvant chemotherapy (NACT) was suggested for control of the disease before surgery, or asadjuvant treatment in combination with radiotherapy after surgery.[3] Concurrent chemoradiation was considered instead of radiotherapy alone in women with cervical cancer in 1999[4]; However, a subsequent meta-analysis suggested that NACT followed by surgery is superior to radiotherapy alone in terms of overall survival. [5] The authors have no funding and conflicts of interest to disclose. The datasets generated during and/or analyzed during the current study are not publicly available, but are available from the corresponding author on reasonable re

FAQs

What is the purpose of measuring HIF-1α, VEGF-A, and Ki67 in this study?

The study investigates whether these biomarkers can be effective and predictive for evaluating NACT efficacy in locally advanced cervical cancer.

How were biomarker expressions evaluated in the study?

HIF-1α, VEGF-A, and Ki67 were detected using immunohistochemistry in 42 paired tissues (pre-NACT and post-NACT) and 40 nonneoplastic cervical epithelial tissues.

What did the results show about biomarker expression after NACT?

HIF-1α, VEGF-A, and Ki67 were overexpressed in tumors compared with nonneoplastic tissues, and their expression significantly decreased after NACT.

Which factors were associated with better NACT response?

Lower histological grade and lower expression of HIF-1α, VEGF-A, and Ki67 were associated with improved responsiveness, and histological grade, HIF-1α, and Ki67 were identified as independent risk factors affecting NACT efficacy.

Sep 24, 2026

Uploaded by Riley