Adding pembrolizumab to chemo improves survival in cervical cancer, finds study

For women with persistent, recurrent, or metastatic cervical cancer, adding pembrolizumab to chemotherapy, with or without bevacizumab, is associated with improved overall and progression-free survival, according to a study presented at the annual meeting of the American Society of Clinical Oncology, held from June 2 to 6 in Chicago.

Bradley Monk, M.D., from the Creighton University School of Medicine in Phoenix, and colleagues presented the protocol-specified final overall survival analysis results of KEYNOTE-826, involving eligible adults with persistent, recurrent, or metastatic cervical cancer not previously treated with systemic chemotherapy and not amenable to curative treatment. Participants were randomly assigned to pembrolizumab or placebo for up to 35 cycles plus chemotherapy (paclitaxel, cisplatin, or carboplatin) with or without bevacizumab.

A total of 617 patients were randomly assigned (308 to pembrolizumab + chemotherapy [63.6 percent with bevacizumab] and 309 to placebo + chemotherapy [62.5 percent with bevacizumab]).

The researchers found that pembrolizumab + chemotherapy significantly improved overall survival and progression-free survival in programmed death ligand 1 combined positive score (CPS) ≥1, all-comer, and CPS ≥10 populations (overall survival: hazard ratios, 0.60, 0.63, and 0.58, respectively; progression-free survival: hazard ratios, 0.58, 0.61, and 0.52, respectively). The benefit for pembrolizumab + chemotherapy was independent of bevacizumab use.

"Before KEYNOTE-826, the standard of care was a platinum-based paclitaxel chemotherapy combination with or without bevacizumab treatment for people with this diagnosis," Monk said in a statement. "This study demonstrates that giving immunotherapy earlier provides a substantial overall survival benefit compared with the second-line setting."

The study was funded by Merck, which manufactures pembrolizumab.

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