Pembrolizumab + carboplatin + paclitaxel ± bevacizumab (persistent/recurrent/metastatic cervical 1L PD-L1 CPS ≥1, KEYNOTE-826)
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| Composantes | DRUG-PEMBROLIZUMAB DRUG-CARBOPLATIN DRUG-PACLITAXEL DRUG-BEVACIZUMAB |
|---|
| ID | REG-PEMBROLIZUMAB-CERVICAL-1L |
|---|---|
| Type | Protocole thérapeutique |
| État | reviewed 2026-04-29 | pending_clinical_signoff |
| Maladies | Aucune déclaration |
| Sources | SRC-ESMO-CERVICAL-2024 SRC-KEYNOTE-826-COLOMBO-2021 SRC-NCCN-CERVICAL-2025 |
Notes
KEYNOTE-826 (Colombo NEJM 2021, n=617) established pembrolizumab + platinum-doublet (carboplatin or cisplatin + paclitaxel) ± bevacizumab as 1L standard for persistent / recurrent / metastatic cervical cancer with PD-L1 CPS ≥1 (which is ~88% of cervical cancers). PFS HR 0.65 (95% CI 0.53–0.79), OS HR 0.67 (95% CI 0.54–0.84) in CPS ≥1 population; benefit consistent across all pre-specified subgroups including bevacizumab-add stratum. FDA approval Oct 2021 (CPS ≥1); EMA approval 2022. Bevacizumab add-on per investigator discretion in KEYNOTE-826 — recommended where no contraindication (no high fistula risk from prior pelvic RT, no controlled hypertension, no recent surgery, no thromboembolic history). PD-L1 CPS testing by 22C3 IHC is the companion biomarker. Standard PD-1 irAE spectrum + bevacizumab class AEs (HTN, proteinuria, fistula risk); cervical- specific fistula concern given prior pelvic RT in many patients.
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