Dr Duska on the Adoption of Pembrolizumab Plus Concurrent CRT as a SOC in Advanced Cervical Cancer

"The results of this study suggest that, for this patient population, pembrolizumab in combination with concurrent chemoradiation should be the SOC. However, there are parts of the world where this kind of treatment is not available; therefore, we have to continue to do more work and do better for patients with locally advanced cervical cancer."

Linda R. Duska, MD, MPH, a gynecologic oncologist at the University of Virginia Health, discusses the clinical implications of data from the second interim analysis of the phase 3 KEYNOTE-A18 trial (NCT04221945), and next steps for the evaluation of pembrolizumab (Keytruda) and chemoradiotherapy, followed by pembrolizumab, in patients with newly diagnosed, previously untreated, high-risk, stage IB2 to IIB, node-positive or stage III to IVA locally advanced cervical cancer.

Data from the second interim analysis of the phase 3 KEYNOTE-A18 trial (NCT04221945), which were presented at the 2025 SGO Annual Meeting on Women’s Cancer, demonstrated that the regimen produced statistically significant and clinically meaningful improvements in overall survival (OS) and time to second disease progression or death (PFS2), as well as a sustained progression-free survival (PFS) benefit compared with standard chemoradiotherapy alone. These data support a paradigm shift in the treatment of this high-risk population, for whom long-term outcomes with chemoradiotherapy alone have historically been poor.

Duska emphasized that these findings support the incorporation of pembrolizumab in combination with concurrent chemoradiotherapy as a new standard of care in appropriate settings. However, access to this combination remains a challenge in resource-limited settings, underscoring the need for global efforts to ensure equitable availability of advanced therapies, she noted.

Although data from the final analysis are still pending, Duska highlighted the importance of continuing research efforts in this space. In particular, she stressed the ongoing need to focus on prevention strategies, including HPV vaccination and improved screening, which remain critical for reducing the incidence of cervical cancer worldwide. As new data continue to emerge, further opportunities to refine treatment approaches and improve outcomes for patients with locally advanced cervical cancer are anticipated, Duska concluded.