Advanced Cervical Cancer: Leveraging the Historical Threshold of Overall Survival

Abstract

Cervical cancer is a public health problem in low- and middle-income countries, where many patients are diagnosed at an advanced stage. After the Gynecology Oncology Group (GOG) 240 study, the first-line standard of care for patients in recurrent and/or metastatic settings includes the incorporation of bevacizumab with chemotherapy. Regarding the second line, no drug demonstrates a survival benefit and, therefore, no therapy can be considered the gold standard. The association of human papillomavirus (HPV) infection and immunosuppression with an increased risk of cervical cancer led to the hypothesis that the immune system may have an important role in this disease. More recently, pembrolizumab received Food and Drug Administration (FDA) approval as second-line therapy based on durable responses for patients with cervical cancer who expressed a combined positive score of > 1%, although the response rate (RR) in this scenario was still poor (14%)