A 35-year-old woman with cervical carcinoma Stage IVB is referred for palliative chemotherapy. The backbone of systemic therapy for recurrent/metastatic cervical cancer is:
- A Carboplatin + paclitaxel alone
- B Cisplatin monotherapy
- C Carboplatin + paclitaxel + bevacizumab, with pembrolizumab for PD-L1 positive tumours ✓
- D Gemcitabine + cisplatin
Correct answer: C. Carboplatin + paclitaxel + bevacizumab, with pembrolizumab for PD-L1 positive tumours
Explanation
For recurrent/metastatic cervical cancer, the GOG-240 trial established that adding bevacizumab to carboplatin/paclitaxel improves overall survival. Subsequently, KEYNOTE-826 demonstrated that adding pembrolizumab (anti-PD-1) to chemotherapy ± bevacizumab significantly improves progression-free and overall survival in PD-L1 positive tumours (CPS ≥1), making this the current standard. Cisplatin monotherapy has historical use but inferior outcomes.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.