ESMO Gynae 2025 | 2025 updates in the management of locally advanced cervical cancer
Domenica Lorusso, MD, PhD, Fondazione IRCCS National Cancer Institute of Milan, Milan, Italy, highlights the potential of combining immunotherapy with radiotherapy for the treatment of locally advanced cervical cancer. Data from the KEYNOTE-A18 trial (NCT04221945) supports this notion, where radiotherapy can induce immunogenic death, which is enhanced by the addition of pembrolizumab. This approach has been approved as the new standard for stage 3 cervical cancer. This interview took place at 2025 European Society for Medical Oncology (ESMO) Gynaecological Cancers Congress in Vienna, Austria.
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Transcript
Oh, that’s another very important point. Since more than 25 years, we have only had chemoradiation for the treatment of locally advanced cervical cancer. And honestly, modern radiotherapy is very effective. Image-guided, adaptive radiotherapy has increased local control and reduced toxicity in patients with cervical cancer. And actually, about 80% of patients at stage 2 are alive at 5 years...
Oh, that’s another very important point. Since more than 25 years, we have only had chemoradiation for the treatment of locally advanced cervical cancer. And honestly, modern radiotherapy is very effective. Image-guided, adaptive radiotherapy has increased local control and reduced toxicity in patients with cervical cancer. And actually, about 80% of patients at stage 2 are alive at 5 years. But there is a strong rationale in combining immunotherapy plus radiotherapy because radiotherapy can induce immunogenic death. And this was explored in KEYNOTE-A18, which is a randomized trial combining pembrolizumab with chemoradiation and as maintenance. With respect to chemoradiation in locally advanced high-risk cervical cancer, about 85% of patients had node-positive, 55% at stage 3-4. And we demonstrate that when we combine pembrolizumab with chemoradiation, we significantly increase progression-free survival with a hazard ratio of 0.70 and overall survival with a hazard ratio of 0.68. And this is the new standard that has been already approved for stage 3.
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