Improving survival from metastatic, recurrent, or persistent cervical cancer
Mené sur 410 patientes atteintes d'un cancer du col de l'utérus persistant, récidivant ou de stade métastatique, cet essai de phase III évalue l'efficacité, du point de vue de la survie sans progression et de la survie globale, et la toxicité de l'ajout de l'atézolizumab à un traitement de première ligne combinant bévacizumab et chimiothérapie
Résumé en anglais
Cervical cancer is a major cause of death and morbidity worldwide, and prognosis remains poor in those with advanced disease. 1 We welcome the publication in The Lancet of the BEATcc trial (ENGOT-Cx10–GEICO 68-C–JGOG1084–GOG-3030), which shows a significant survival advantage from adding an immune checkpoint inhibitor to standard-of-care therapy. 2 Previously, the phase 3 Gynaecologic Oncology Group 240 trial established chemotherapy in combination with bevacizumab as standard first-line treatment for incurable cervical cancer, with a median overall survival of approximately 17 months. 3 The Keynote-826 trial produced compelling evidence supporting the use of immune checkpoint inhibitors, specifically PD-1 inhibitors, in metastatic cervical cancer. Keynote-826 was a phase 3 trial exploring the addition of pembrolizumab to first-line chemotherapy (with or without bevacizumab at physician discretion) and showed a significantly improved overall survival of 26·4 months versus 16·8 months (hazard ratio [HR] 0·63 95% CI 0·52–0·77) in their all-comer population. 4 The greatest benefit was seen in the PD-L1 positive (≥1 combined positive score) cohort, with the Keynote-826 data leading to pembrolizumab plus chemotherapy being approved in many countries, in some instances only for patients who are PD-L1 positive.
