Cervical cancer is the fourth most common cancer in women worldwide. For patients with persistent, recurrent, or metastatic disease, treatment options were historically limited. Pembrolizumab has changed that picture, establishing itself as a standard component of first-line treatment for eligible patients with advanced cervical cancer.
The role of HPV and immunotherapy
Most cervical cancers are caused by persistent infection with high-risk strains of human papillomavirus (HPV). HPV-driven tumours are highly immunogenic - they contain viral proteins that the immune system can potentially recognise as foreign. This makes them good candidates for checkpoint inhibitor therapy. The PD-L1/PD-1 pathway is active in many cervical tumours, and blocking it with pembrolizumab allows T cells to mount a response against HPV-associated cancer cells.
KEYNOTE-826: First-line cervical cancer
The pivotal trial for pembrolizumab in cervical cancer was KEYNOTE-826, which evaluated pembrolizumab in combination with platinum-based chemotherapy (with or without bevacizumab) versus chemotherapy alone in patients with persistent, recurrent, or metastatic cervical cancer. Patients with a PD-L1 CPS of 1 or higher derived significant benefit from adding pembrolizumab. Median overall survival was 28.6 months in the pembrolizumab arm versus 16.5 months in the chemotherapy-alone arm - a clinically meaningful difference in a disease with historically poor outcomes in the advanced setting.
PD-L1 requirements
For the cervical cancer indication, pembrolizumab is approved for patients with CPS 1 or higher - a threshold met by the majority of patients with this cancer type. PD-L1 testing is performed on tumour tissue, and most oncologists who manage cervical cancer will be familiar with the scoring process. If you have not yet had PD-L1 testing, your oncologist can arrange this through your existing biopsy or surgical specimen in most cases.
What this means for patients
For women with advanced cervical cancer who meet the eligibility criteria, pembrolizumab in combination with chemotherapy has become the standard first-line approach. The subcutaneous pembrolizumab formulation can be delivered at home once initial combination chemotherapy cycles are complete, reducing the ongoing treatment burden for patients managing a demanding disease and its effects on daily life.
Diagnosed with advanced cervical cancer?
Our eligibility check covers your cancer type, CPS result, and treatment history. An oncologist reviews every submission within 24 hours.
Check your eligibility