Cervical Cancer, 82.6% Patients Alive at 3 Years with Immunotherapy and Chemotherapy

More than 8 out of 10 women with high-risk, locally advanced cervical cancer survive 3 years after immunotherapy with pembrolizumab, in combination with concomitant chemoradiotherapy. This is what emerges from the Keynote-A18 study, also known as Engot-cx11/Gog-304, presented at the presidential symposium of the ESMO (European Society for Medical Oncology) congress that these days brings together thousands of oncologists from all over the world in Barcelona, ​​and published simultaneously in ‘The Lancet’.

According to the study, coordinated by Italian Domenica Lorusso, immunotherapy with pembrolizumab, in combination with concomitant chemoradiotherapy (CRT), reduced the risk of death by 33% (HR = 0.67) compared to concomitant chemotherapy alone. Overall survival at 3 years reached 82.6% in patients with a new diagnosis who received the immunotherapy regimen compared to 74.8% for those who were treated with concomitant chemotherapy alone. This is the first time in over 20 years that there has been an improvement in overall survival in high-risk locally advanced cervical cancer.

Every year in Italy, approximately 2,500 new diagnoses of cervical cancer are estimated. “It is one of the main causes of cancer death in women globally, but therapeutic progress in recent years has not demonstrated a significant survival benefit for patients with high-risk, locally advanced disease – explains Lorusso, principal investigator of the Keynote-A18 study, lead investigator for Engot, full professor of Obstetrics and Gynecology at Humanitas University and Director of the Gynecological Oncology Program at Humanitas San Pio X in Milan – The combination of pembrolizumab with exclusive concomitant chemoradiotherapy increases overall survival in these patients in a statistically significant and clinically relevant way. For the first time in over 20 years in which there has been no real progress, this combination changes the standard of care, until now represented by concomitant chemoradiotherapy alone”.

“We are very proud of the result obtained, presented in the Presidential Symposium – continues Lorusso – At the Esmo 2023 Congress, the progression-free survival results were illustrated. The updated data, which also include overall survival, consolidate the value of the new combination. The addition of immunotherapy with pembrolizumab to chemoradiotherapy will allow a greater number of patients to potentially be cured. In fact, we remind you that this is a potentially curative stage of the disease”.

“The Keynote-A18 study highlights the high level of Italian researchers, who are able to open new paths in the challenge of the disease – says Francesco Perrone, president of Aiom (Italian Association of Medical Oncology) – Cervical cancer often affects young women, busy with their profession and family, with small children. Furthermore, it is a very symptomatic and painful neoplasm, which prevents a social life. Hence the importance of innovation that offers therapies that improve survival and allow us to achieve, in some cases, the very important goal of healing”.

“The eradication of the disease, which is almost always caused by HPV, the human papillomavirus, the most frequent sexually transmitted infection, is only possible by investing in prevention programs – continues Perrone – The ‘calls to action’ promoted by the World Health Organization, the European CanCer Organisation and the ‘Europe’s Beating Cancer Plan’ of the European Commission aim to eliminate cervical cancer and all HPV-related cancers by 2030. It is necessary to act on 3 areas of intervention: primary prevention with the improvement of vaccination coverage against HPV, secondary prevention with screening through the Pap test or the HPV test and access to treatments for lesions or cancer of the cervix”.