What are the treatment options for recurrent or metastatic cervical cancer?

Updated: Feb 12, 2019
  • Author: Cecelia H Boardman, MD; Chief Editor: Warner K Huh, MD  more...
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Answer

Recurrences arising in a previously irradiated field or after a disease-free interval of less than 16 months are less likely to respond to subsequent therapies. Consequently, patients with such recurrences should be strongly encouraged to participate in clinical trials. Special efforts should be made to ensure that they receive comprehensive palliative care, including adequate pain control.

In June 2018, the FDA approved pembrolizumab for treatment of recurrent or metastatic cervical cancer with disease progression on or after chemotherapy whose tumors express PD-L1 (CPS 1 or greater) as determined by an FDA-approved test. Approval was based on the KEYNOTE-158 clinical trial (n=98). For the 77 patients whose tumors expressed PD-L1 with a CPS of 1 or greater, the ORR was 14.3%, with a CRR of 2.6% and partial response rate of 11.7%. Among the 11 responding patients, median duration of response was not yet reached (range, 4.1 to 18.6+ months) and 91% experienced a DOR of 6 months or longer. The median follow-up time was 11.7 months (range, 0.6 to 22.7 months). [112]


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