Dr Duska on the Efficacy of Pembrolizumab Plus Concurrent CRT in Advanced Cervical Cancer

Linda R. Duska, MD, MPH, a gynecologic oncologist at the University of Virginia Health, discussed efficacy outcomes with the combination of pembrolizumab (Keytruda) and chemoradiotherapy followed by pembrolizumab monotherapy, in patients with newly diagnosed, 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) presented at the 2025 SGO Annual Meeting on Women’s Cancer demonstrated that the combination regimen led to statistically significant and clinically meaningful improvements in overall survival (OS) and time to second disease progression or death (PFS2) compared with chemoradiotherapy plus placebo in this patient population. The data also showed a sustained progression-free survival (PFS) benefit with the combination, Duska reported.

At the second interim analysis, the median OS was not reached (NR) in both arms, with 14.2% of patients in the pembrolizumab arm experiencing an OS event compared with 20.5% of those in the placebo arm (HR, 0.67; 95% CI, 0.50-0.90; P = .0040). The 36-month OS rates were 82.6% (95% CI, 78.4%-86.1%) in the pembrolizumab arm compared with 74.8% (95% CI, 70.1%-78.8%) in the placebo arm.

Regarding PFS2, the median time to event was NR in both arms, with events occurring in 15.3% of patients in the pembrolizumab arm and 24.3% of those in the placebo arm (HR, 0.60; 95% CI, 0.46-0.80). The PFS data showed that 29.3% of patients in the pembrolizumab arm experienced a PFS event compared with 39.5% of those in the placebo arm. The median PFS was NR in both arms (HR, 0.68; 95% CI, 0.56-0.84). The 36-month PFS rates were 62.7% (95% CI, 56.4%-68.4%) in the pembrolizumab arm and 54.5% (95% CI, 49.3%-59.3%) in the placebo arm. These data are exciting as they represent a significant treatment advancement for patients with high-risk locally advanced cervical cancer, Duska concluded.