Neoadjuvant chemotherapy in locally advanced clear cell carcinoma of the cervix leading to complete disease resolution; a case report

• Clear cell carcinoma of the cervix is a rare form of cervical cancer, typically treated akin to other subtypes of cervical cancer. • Unlike other subtypes of cervical cancer, clear cell carcinoma is radioresistant, presenting challenges in treatment of locally advance disease. • This article presents a case of locally advanced clear cell carcinoma of the cervix treated with neoadjuvant chemotherapy, followed by radical hysterectomy, with final pathology showing no residual disease. Cervical clear cell carcinoma, a rare form of cervical adenocarcinoma, is traditionally treated with regimens based on those used in more prevalent forms of cervical cancer. However, those with locally advanced disease typically have worse outcomes, likely due to its poor radiosensitivity, raising the question whether alternative treatment regimens should be considered. This paper presents the case of a 46-year-old female with newly diagnosed locally advanced clear cell cervical carcinoma who underwent treatment with neoadjuvant chemotherapy with cisplatin/paclitaxel/pembrolizumab/bevacizumab followed by radical hysterectomy. Post-treatment imaging and post-operative final pathology specimen showed complete resolution of disease. This is the first report to our knowledge of this novel neoadjuvant treatment regimen for cervical clear cell carcinoma; based on this patient’s excellent response, further investigation is needed to clarify the optimal neoadjuvant treatment for patients with this rare and difficult to treat disease.