High-risk cervical cancer: 82.6% of patients are alive after 3 years by adding immunotherapy

According to Prof. Domenica Lorusso, who led the study, this is the first significant progress in over 20 years. The new combination of therapies is improving the standard of care and could potentially allow more patients to be cured

Italian research breaks new ground in clinical practice in locally advanced high-risk cervical cancer: the KEYNOTE-A18 trial found that when administered in combination with chemoradiation therapy, pembrolizumab immunotherapy reduced the risk of death by 33% compared to chemoradiation therapy alone.

The study was initiated and co-ordinated by Domenica Lorusso – now Head of Gynecological Oncology at Humanitas San Pio X and full professor at Humanitas University – and was conducted while Prof. Lorusso was Head of Clinical Research Programming Unit at the Agostino Gemelli IRCCS University Polyclinic Foundation in Rome.

Thanks to the new combined approach in which the immunotherapy regimen is also present, overall survival at 3 years reached 82.6% in newly diagnosed patients compared to 74.8% for those treated with chemoradiation therapy alone.

These findings were presented at the Presidential Symposium of the ESMO Congress of the European Society for Medical Oncology, in Barcelona, and published in The Lancet.

A historical breakthrough in treatment effectiveness

Every year in Italy, there are an estimated 2500 new diagnoses of cervical cancer. The disease often affects young women, busy with their carreer and family, and is a very symptomatic and painful neoplasm that prevents social life. This is why the results achieved today is so important: it is the first time in over 20 years that there has been an improvement in overall survival in locally advanced high-risk cervical cancer.

‘Cervical cancer is one of the leading causes of cancer-related deaths in women globally, but therapeutic advances in recent years have not demonstrated a significant survival benefit for patients with locally advanced high-risk disease,’ explains Domenica Lorusso, Principal Investigator of the KEYNOTE-A18 study. ‘The combination of pembrolizumab, which is an immunotherapy, with concomitant chemo-radiotherapy improves overall survival in these patients in a statistically significant and clinically relevant way. For the first time in over 20 years of no real progress, this combination changes the standard of care, which until now has been represented by chemo-radiotherapy alone’.

A central goal remains the long-term eradication of the disease, which is almost always caused by the HPV virus, the most frequent sexually transmitted infection. This is the goal that various strategies implemented by the World Health Organisation, the European Cancer Organisation and the Beating Cancer Plan promoted by the European Commission are aiming at: to eliminate cervical cancer by 2030.

This requires action in three areas: primary prevention with improved HPV vaccination coverage, secondary prevention with screening through the Pap test or HPV test, and access to increasingly effective treatments in case of diagnosis of lesions or cancer.