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This review presents current evidence and future directions for ICIs across cervical, endometrial, and ovarian cancers, including rare tumors. Efficacy is highlighted in high tumor mutational burden and immune marker–positive disease such as PD-L1 expression and microsatellite instability, while challenges persist for microsatellite stable endometrial and epithelial ovarian cancers. Combination strategies and the need for management of immune-related adverse events and reliable biomarkers are emphasized.",{"@graph":69,"@context":123},[70,84,106],{"@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/immune-checkpoint-inhibitors-in-gynecologic-oncology-current-status-and-perspectives/370883/",{"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/immune-checkpoint-inhibitors-in-gynecologic-oncology-current-status-and-perspectives/370883.png","ImageObject",300,407,{"name":92,"@type":93},"Jasmine","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-25","2026-09-23",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",12,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"Which gynecologic cancers are covered in the review?","Question",{"text":113,"@type":114},"The review focuses on ICIs in cervical, endometrial, and ovarian cancers, and also discusses rare tumors.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"What tumor features are associated with better response to ICIs?",{"text":118,"@type":114},"Improved outcomes are described for tumors with high tumor mutational burden, high microsatellite instability, and elevated immune markers such as PD-L1 expression and neoantigen expression.",{"name":120,"@type":111,"acceptedAnswer":121},"Why are microsatellite stable endometrial and epithelial ovarian cancers more challenging?",{"text":122,"@type":114},"The review notes that these cancers tend to be relatively less immunogenic, which makes effective responses to ICIs harder to achieve.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},370883,1790848335,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":140,"language":141,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":67,"update_tm":145,"read_time":146},2336478487870,"https://ap-avatar.wpscdn.com/davatar_085a072bc5b1113ac321206ff7593b45","DOI: 10. 1002/ijgo.70280  \nS U PPL E M E NT A RT I C L E  \nImmune checkpoint inhibitors in gynecologic oncology: Current status and perspectives  \nNozomu Yanaihara1  | Ka Yu Tse2 | Sung Jong Lee3 | Ji Geun Yoo4 | Sarikapan Wilailak5  \n1Department of Obstetrics and Gynecology, The Jikei University School of Medicine, Tokyo, Japan  \n2Department of Obstetrics and Gynaecology, The University of Hong Kong, Pokfulam, Hong Kong 3 Department of Obstetrics and Gynecology, Seoul St. Mary‘s Hospital, The Catholic University of Korea, Seoul, Republic of Korea  \n4Department of Obstetrics and Gynecology, Daejeon St. Mary‘s Hospital, The Catholic University of Korea, Daejeon, Republic of Korea  \n5Department of Obstetrics and Gynecology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand  \nCorrespondence  \nNozomu Yanaihara, Department of Obstetrics and Gynecology, The Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi, Minato-ku, Tokyo 105- 8461, Japan. [Email:](Email: yanazou@outlook.com)[ yanazou@outlook.com](Email: yanazou@outlook.com)  \n1 | INTRODUCTION  \nAbstract  \nImmune checkpoint inhibitors (ICIs) have transformed cancer treatment by leveraging the immune system's capacity to fight gynecologic cancer. This review summarizes the current status and future perspectives of ICIs in the treatment of cervical, endometrial, and ovarian cancers and rare tumors. ICIs have demonstrated significant efficacy in tumors with high tumor mutational burden and immune markers such as PD-L1 expression and microsatellite instability. In cervical cancer, the integration of ICIs has shown promise at various stages of treatment, including advanced and recurrent settings. In endometrial cancer, molecular classification has facilitated targeted immunotherapy strategies, with notable success in mismatch repair-deficient (dMMR) tumors. However, challenges remain in the treatment of microsatellite stable endometrial and epithelial ovarian cancers due to their relatively low immunogenicity. Combination therapies, including ICIs with angiogenesis inhibitors, poly (ADP-ribose) polymerase (PARP) inhibitors, or chemotherapy, are being actively investigated to improve response rates. Several phase II and case series showed promising response to ICIs in vulvar/vaginal cancer and gestational trophoblastic neoplasia, though the efficacy in genital tract melanoma is still unclear. Despite these advances, the management of immune-related adverse events and the identification of reliable biomarkers for patient selection remain critical. ICIs are poised to redefine the therapeutic landscape of gynecologic oncology, offering hope for improved outcomes and personalized treatment strategies.  \nK E Y WO R D S  \ncervical cancer, endometrial cancer, immune checkpoint inhibitors, ovarian cancer  \nimmunotherapy, particularly immune checkpoint inhibitors (ICIs), has revolutionized the treatment of gynecological malignancies,  \nGynecologic cancers remain one of the leading causes of death in women worldwide. Conventional multidisciplinary treatments such as surgery, radiation therapy, and chemotherapy often have limited efficacy in cases with advanced stages. The introduction of  \nincluding cervical, endometrial, and ovarian cancers. ICIs work by targeting inhibitory pathways used by cancer cells to evade immune detection. Two of the most studied pathways are programmed cell death protein 1 and its ligand (PD-1/PD-L1) and  \n\n| Nozomu Yanaihara, Ka Yu Tse, and Sung Jong Lee contributed equally. |\n| --- |\n| This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited\u003Cbr>© 2025 The Author(s) . International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics. |\n\n[166](166 | wileyonlinelibrary.com/journal/ijgo)[ |](166 | wileyonlin","cbCaif1XxJLH5taE","https://ap.wps.com/l/cbCaif1XxJLH5taE","pdf",1956327,23,"English","# Introduction\n## Immune checkpoint inhibitors and therapeutic rationale\n## Evidence of efficacy and key biomarkers\n## Combination approaches and remaining challenges","[{\"question\":\"Which gynecologic cancers are covered in the review?\",\"answer\":\"The review focuses on ICIs in cervical, endometrial, and ovarian cancers, and also discusses rare tumors.\"},{\"question\":\"What tumor features are associated with better response to ICIs?\",\"answer\":\"Improved outcomes are described for tumors with high tumor mutational burden, high microsatellite instability, and elevated immune markers such as PD-L1 expression and neoantigen expression.\"},{\"question\":\"Why are microsatellite stable endometrial and epithelial ovarian cancers more challenging?\",\"answer\":\"The review notes that these cancers tend to be relatively less immunogenic, which makes effective responses to ICIs harder to achieve.\"}]","Immune checkpoint inhibitors in gynecologic oncology - Current status and perspectives | PDF",1790190753,58]