July 18, 2024

Immunotherapy Outperforms Standard Therapy in Metastatic or Recurrent Cervical Cancer, Improving Survival

A groundbreaking study published in The Lancet has shown that incorporating immunotherapy into the first-line standard treatment for metastatic or recurrent cervical cancer significantly enhances both progression-free survival (PFS) and overall survival (OS) in patients who are not eligible for curative surgery or radiotherapy. These individuals often face a bleak prognosis with limited treatment options. The current standard of care for these patients involves a combination of cisplatin/paclitaxel chemotherapy and the antiangiogenic agent bevacizumab. Approval for this therapeutic approach was based on the results of a previous phase III trial known as the Gynecologic Oncology Group (GOG) 240 trial, which reported a median OS of 17 months and a PFS of 8.2 months.

Led by Ana Oaknin, the Principal Investigator of the Vall d’Hebron Institute of Oncology’s (VHIO) Gynecological Malignancies Group and a Medical Oncologist at the Vall d’Hebron University Hospital (HUVH), the academic phase III BEATcc trial (ENGOT-Cx10/GEICO 68-C/JGOG1084/GOG-3030) aimed to evaluate the benefits of incorporating the PD-L1 checkpoint inhibitor atezolizumab into the standard regimen of first-line chemotherapy plus bevacizumab, regardless of the patient’s PD-L1 status.

The international study, the results of which have now been published in The Lancet, enrolled 410 previously untreated patients with metastatic (stage IVB) or recurrent cervical cancer who were ineligible for curative surgery/radiation. These patients were randomly assigned in a 1:1 ratio to receive either standard therapy or the combination of atezolizumab with standard therapy.

At a median follow-up of 35 months, the median OS for patients who received the combination of atezolizumab and standard therapy was 32.1 months, compared to 22.8 months in the control group. This substantial improvement is unprecedented in this particular context, according to Ana Oaknin, the lead author of the study.

The GOG 240 trial, on which the current standard of care is based, reported a two-year survival rate of less than 40%. However, the interim OS data from the BEATcc trial revealed a two-year survival rate of 60% in patients treated with atezolizumab plus bevacizumab and the chemotherapy doublet.

In addition to the significantly improved OS results, the BEATcc study investigators also observed a substantial enhancement in PFS. The median PFS was 13.7 months in patients treated with the experimental combination, compared to 10.4 months in the control group.

Considering the impact on overall survival, it is imperative to evaluate the addition of atezolizumab to the standard therapy with bevacizumab and chemotherapy in the context of different regulatory authorities and healthcare reimbursement systems. This innovative combination should be regarded as a new first-line treatment option for patients with metastatic or recurrent cervical cancer, as concluded by Ana Oaknin.

1. Source: Coherent Market Insights, Public sources, Desk research
2. We have leveraged AI tools to mine information and compile it