The KEYNOTE-826 trial established the role of pembrolizumab in cervical cancer. In which population and setting did it show a statistically significant improvement in overall survival?
- A Recurrent/metastatic cervical cancer with PD-L1 CPS ≥1, first-line with platinum-based chemotherapy and bevacizumab ✓
- B Locally advanced cervical cancer (Stage IIB-IVA) added to concurrent chemoradiation
- C Recurrent cervical cancer after two prior lines of platinum-based chemotherapy
- D Early-stage cervical cancer (Stage IA2-IIA) adjuvant after radical hysterectomy
Correct answer: A. Recurrent/metastatic cervical cancer with PD-L1 CPS ≥1, first-line with platinum-based chemotherapy and bevacizumab
Explanation
KEYNOTE-826 (NEJM 2021) randomised patients with persistent, recurrent, or metastatic cervical cancer to pembrolizumab versus placebo, both added to platinum-chemotherapy ± bevacizumab. In the PD-L1 CPS ≥1 population, pembrolizumab significantly improved progression-free survival (PFS) and overall survival (OS). This established pembrolizumab as first-line standard of care for recurrent/metastatic cervical cancer with PD-L1 expression. The drug is not yet standard in concurrent chemoradiation (CALLA trial tested cemiplimab in this setting, results pending).
Reference: Shaw's Textbook of Gynaecology, 17th ed.
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