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Because these processes share overlapping biology, focusing on common mechanisms can improve therapeutic effectiveness. CD44, a metastatic-promoting stem cell marker abundant in cervical cancer cells, links to both metastatic behavior and chemoresistance. Existing advanced-stage regimens such as platinum chemotherapy often fail to cure. This review evaluates whether immune checkpoint inhibition targeting CTLA-4 and PD-1/PD-L1 can reduce CD44-induced EMT, metastasis, and chemoresistance.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/highlighting-the-role-of-cd44-in-cervical-cancer-progression-immunotherapys-potential-in-inhibiting-metastasis-and-chemoresistance/331192/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/highlighting-the-role-of-cd44-in-cervical-cancer-progression-immunotherapys-potential-in-inhibiting-metastasis-and-chemoresistance/331192.png","ImageObject",300,407,{"name":92,"@type":93},"Ezra","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-29","2026-09-21",true,{"@type":102,"interactionType":103,"userInteractionCount":34},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why is cervical cancer treatment challenging in advanced-stage disease?","Question",{"text":112,"@type":113},"Advanced-stage cervical cancer is difficult to cure because platinum-based chemotherapy regimes are often limited and rarely curative, and recurrent disease worsens prognosis. Metastasis and chemoresistance further undermine treatment effectiveness.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What role does CD44 play in cervical cancer progression?",{"text":117,"@type":113},"CD44 is abundant in cervical cancer cells and is associated with both chemoresistance and metastatic mechanisms. The review highlights CD44 as a common target underlying these pathological effects.",{"name":119,"@type":110,"acceptedAnswer":120},"How does immune checkpoint inhibition relate to targeting CD44-linked mechanisms?",{"text":121,"@type":113},"Immune checkpoint inhibitors that target CTLA-4 and PD-1/PD-L1 are proposed as an alternate strategy to counteract CD44-mediated treatment resistance. The review assesses whether they can mitigate CD44-induced EMT, metastasis, and chemoresistance.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},331192,1790657800,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":34,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145},1099514068035,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","Immunologic Research (2024) 72:592–604  \n[https://doi.org/10.1007/s12026-024-09493-6](https://doi.org/10.1007/s12026-024-09493-6)  \nHighlighting the role of CD44 in cervical cancer  \nprogression: immunotherapy’s potential in inhibiting metastasis and chemoresistance  \nCayleigh de Sousa1 · Carla Eksteen1 · Johann Riedemann2 · Anna‑Mart Engelbrecht1  \nReceived: 26 March 2024 / Accepted: 16 May 2024 / Published online: 31 May 2024 © The Author(s) 2024  \nAbstract  \nCervical cancer affects thousands of women globally with recurring high-risk HPV infections being at the centre of cervical pathology. Oncological treatment strategies are continually challenged by both chemoresistance and metastasis within patients. Although both work hand-in-hand, targeting their individual mechanisms could prove highly beneficial for treatment outcomes. Such targets include the metastatic-promoting stem cell marker, CD44, which is abundant in cervical cancer cells and is common to both chemoresistance and metastatic mechanisms. Seeing that many existing advanced-stage cervical cancer treatment regimes, such as platinum-based chemotherapy regimens, remain limited and are rarely curative, alternative treatment options within the field of immunology are being considered. The use of immune checkpoint inhibition therapy, which targets immune checkpoints, CTLA-4 and PD-1/PD-L1, has shown promise as an alternate standard of care for patients suffering from advanced-stage cervical cancer. Therefore, this review aims to assess whether immune checkpoint inhibition can mitigate the pathological effects of CD44-induced EMT, metastasis, and chemoresistance in cervical cancer patients.  \nKeywords Cervical cancer · Immunology · Metastasis · CD44 · EMT · Immune checkpoints  \nIntroduction  \nCervical cancer remains a major health concern affecting women globally [1] . Common associated risk factors for cervical cancer include prolonged oral contraceptive use, smoking, numerous sexual partners, poor nutritional habits [2], and human immunodeficiency virus (HIV) [3] . However, human papillomavirus infection (HPV) continues to  \n* Anna-Mart Engelbrecht [AME@sun.ac.za](AME@sun.ac.za)  \nCayleigh de Sousa  \n[22666990@sun.ac.za](22666990@sun.ac.za)  \nCarla Eksteen  \n[ceksteen@sun.ac.za](ceksteen@sun.ac.za)  \nJohann Riedemann  \n[johann.riedemann@cancercare.co.za](johann.riedemann@cancercare.co.za)  \n1 Department of Physiological Sciences, Faculty of Science, Stellenbosch University, Mike de Vries Building, C/o Merriman and Bosman Street, Stellenbosch 7600, South Africa  \n2 Cancercare, Cape Town, South Africa  \nbe the primary cause of malignancy, specifically infection with high-risk HPV subtypes, such as HPV16 and HPV18 [4] . Cervical oncogenesis is primarily driven by high-risk HPV oncogenes, E5, E6, and E7 as these oncogenes evade the immune system whilst simultaneously disrupting physiological host genome cellular functioning mechanisms [5] . Cervical cancer treatment remains a challenge that often requires the combined use of various treatment modalities such as radiation, surgery, and chemotherapy [1] . Treatment is largely dependent on the International Federation of Gynecology and Obstetrics (FIGO) staging system (I–IV)  \n[1] as well as the extent of the disease [4] . The standard of care (SOC) for low-risk/early-stage cancer patients typically include surgical resection. Locally advanced cervical disease is more challenging to treat and often requires concurrent chemoradiation therapeutic approaches [6] . Platinum-based chemotherapeutic drugs, such as cisplatin and taxanes such as paclitaxel, are most commonly used for cervical malignancy and have proven most effective [6] . Their administration in advanced-stage patients, both individually and in combination, has been shown to increase patients’ overall survival [7]. The overall patient prognostic potential largely decreases as the disease becomes recurrent/metastatic [4] .  \nFurthermore, despite the development of t","cbCaibGvGmRGen6e","https://ap.wps.com/l/cbCaibGvGmRGen6e","pdf",1657733,13,"English","# Abstract\n# Introduction\n## Cervical cancer and metastasis","[{\"question\":\"Why is cervical cancer treatment challenging in advanced-stage disease?\",\"answer\":\"Advanced-stage cervical cancer is difficult to cure because platinum-based chemotherapy regimes are often limited and rarely curative, and recurrent disease worsens prognosis. Metastasis and chemoresistance further undermine treatment effectiveness.\"},{\"question\":\"What role does CD44 play in cervical cancer progression?\",\"answer\":\"CD44 is abundant in cervical cancer cells and is associated with both chemoresistance and metastatic mechanisms. The review highlights CD44 as a common target underlying these pathological effects.\"},{\"question\":\"How does immune checkpoint inhibition relate to targeting CD44-linked mechanisms?\",\"answer\":\"Immune checkpoint inhibitors that target CTLA-4 and PD-1/PD-L1 are proposed as an alternate strategy to counteract CD44-mediated treatment resistance. The review assesses whether they can mitigate CD44-induced EMT, metastasis, and chemoresistance.\"}]","Highlighting the role of CD44 in cervical cancer progression - immunotherapy’s potential in inhibiting metastasis and chemoresistance | PDF",1789992099,33]