Complete remission of small cell neuroendocrine carcinoma of the cervix treated with chemotherapy of paclitaxel, carboplatin, bevacizumab and pembrolizumab: A case report

Background Small cell neuroendocrine carcinoma (SCNEC) of the cervix is a rare and aggressive histological subtype associated with a poor prognosis. Here, we report a case of stage IVB cervical SCNEC that achieved a complete remission following first-line treatment with a combination of chemotherapy, anti-angiogenic therapy, and immune checkpoint inhibition. Case presentation A 42-year-old woman presented with genital bleeding and vaginal discharge. Computed tomography (CT) revealed a cervical lesion with peritoneal dissemination and multiple subcutaneous metastases. Positron emission tomography-computed tomography (PET-CT) confirmed para -aortic lymph node involvement and widespread metastatic disease. Cervical biopsy confirmed SCNEC, with positive immunohistochemical staining for synaptophysin and CD56. The patient received first-line systemic therapy consisting of paclitaxel and carboplatin, in combination with bevacizumab and pembrolizumab. A total of seven cycles were administered, with no life-threatening adverse events. Follow-up PET-CT demonstrated resolution of previously identified lesions, consistent with a complete remission. At 15 months following initiation of therapy, the patient remains on maintenance treatment with bevacizumab and pembrolizumab, with no evidence of disease progression to date. Conclusion This case highlights the potential efficacy of immune checkpoint inhibitor-containing multimodality treatment regimens in the management of advanced cervical SCNEC.