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Immunotherapy in Locally Advanced Cervical Carcinoma: A Narrative Review
Claire Meynard1, Emmanuel Fardeau1, Tiphaine Lambert2
1Radiation Oncology Department, Hôpital Saint-Louis, AP-HP, Université Paris-Cité, 75010 Paris, France.
Cancers
|May 13, 2026
Summary
Pembrolizumab combined with chemoradiotherapy improves survival for advanced cervical cancer. This immunotherapy offers a new standard of care for stage III-IVA disease, enhancing treatment outcomes.
Area of Science:
- Gynecologic Oncology
- Radiation Oncology
- Medical Oncology
Background:
- Standard treatment for locally advanced cervical cancer involves chemoradiotherapy and brachytherapy.
- High-quality radiotherapy, particularly intensity-modulated radiotherapy with image-guided brachytherapy, is crucial for optimal outcomes.
- Recent trials explore novel therapeutic strategies to improve survival rates.
Purpose of the Study:
- To review the biological rationale and clinical trial data for immunotherapy in cervical cancer.
- To critically analyze the results of recent randomized trials, including KEYNOTE A.18 and CALLA.
- To establish quality criteria for chemoradiotherapy and discuss the relevance of new treatments based on patient characteristics.
Main Methods:
- Review of randomized controlled trials evaluating neoadjuvant chemotherapy and immunotherapy in cervical cancer.
- Analysis of the KEYNOTE A.18 trial assessing pembrolizumab in combination with standard chemoradiotherapy.
- Evaluation of the CALLA trial investigating durvalumab addition to standard treatment.
Main Results:
- The KEYNOTE A.18 trial demonstrated an improvement in overall survival with pembrolizumab for stage III-IV cervical cancer.
- The INTERLACE trial suggested a survival benefit with neoadjuvant chemotherapy but faced criticism.
- The CALLA trial evaluating durvalumab did not meet its primary endpoint.
Conclusions:
- Pembrolizumab in addition to standard chemoradiotherapy is recommended for patients with stage III-IVA cervical cancer (FIGO 2014).
- This combination therapy, followed by two years of maintenance, represents a significant advancement in cervical cancer treatment.
- Optimizing chemoradiotherapy quality remains essential alongside novel immunotherapeutic approaches.
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