🌟 First-Line Treatment in Recurrent / Metastatic Cervical Cancer 🌟
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KEYNOTE-826: Pembrolizumab + Chemotherapy ± Bevacizumab ✨💉
Study Design:
🧪 Phase III trial evaluating pembrolizumab combined with chemotherapy (± bevacizumab) for advanced cervical cancer.
👩⚕️ Patients: Persistent, recurrent, or metastatic cervical cancer not amenable to curative treatment.
Key Outcomes:
PD-L1 CPS ≥1 Population:
1. Progression-Free Survival (PFS):
With Bevacizumab: 🩺 15.3 months (pembrolizumab + chemo + bevacizumab) vs. 10.3 months (chemo + bev) (HR = 0.56).
Without Bevacizumab: 🌿 7 months (pembrolizumab + chemo) vs. 6 months (placebo + chemo) (HR = 0.69).
2. Overall Survival (OS):
With Bevacizumab: 🎯 43.9 months (pembrolizumab + chemo + bevacizumab) vs. 23.0 months ( chemo + bev) (HR = 0.60).
Without Bevacizumab: 🌟 17.5 months (pembrolizumab + chemo) vs. 11.9 months ( chemo ).
All Comers Population:
1. Progression-Free Survival (PFS):
With Bevacizumab: 🧬 15.2 months (pembrolizumab + chemo + bevacizumab) vs. 10.2 months (chemo + bev).
Without Bevacizumab: 🌱 6.3 months (pembrolizumab+ chemo) vs. 6.2 months (chemo).
2. Overall Survival (OS):
With Bevacizumab: 🎗️ 37.6 months (pembrolizumab + chemo + bevacizumab) vs. 22.5 months (chemo + bev ).
Without Bevacizumab: 💊 17.1 months (pembrolizumab + chemo) vs. 12.6 months (chemo).
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BEATcc Trial: Atezolizumab + Bevacizumab + Chemotherapy 🌟🎯💉
Study Design:
📜 Open-label Phase III trial evaluating atezolizumab combined with bevacizumab and chemotherapy for metastatic or recurrent cervical cancer.
Key Outcomes:
1. Progression-Free Survival (PFS):
🩺 13.7 months (atezolizumab arm) vs. 10.4 months (control arm) (HR = 0.62).
2. Overall Survival (OS):
🌟 32.1 months (atezolizumab arm) vs. 22.8 months (control arm) (HR = 0.68).
3. Objective Response Rate (ORR):
🎯 84% (atezolizumab arm) vs. 72% (control arm).
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GOG-240: Bevacizumab + Chemotherapy 💉✨
Study Design:
📖 Phase III trial establishing bevacizumab with chemotherapy as the standard for recurrent/metastatic cervical cancer.
Key Outcomes:
1. Progression-Free Survival (PFS):
🧬 8.2 months (bevacizumab arm) vs. 5.9 months (chemo alone).
2. Overall Survival (OS):
🎗️ 17.0 months (bevacizumab arm) vs. 13.3 months (chemo alone).
3. Objective Response Rate (ORR):
🌟 48% (bevacizumab) vs. 36% (without).
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EMPOWER-Cervical 1: Cemiplimab ✨
Study Design:
🧪 Phase III trial investigating cemiplimab monotherapy a PD-1 inhibitor, for platinum-refractory recurrent/metastatic cervical cancer.
Key Outcomes:
1. Progression-Free Survival (PFS):
🩺 4.2 months (cemiplimab) vs. 3.0 months (chemotherapy).
2. Overall Survival (OS):
🌟 11.7 months (cemiplimab) vs. 8.5 months (chemo) (HR = 0.66).
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Key Insights:
1. 🌟 Quadruplet Regimen: Combining immunotherapy, a chemotherapy doublet, and bevacizumab provides outstanding PFS and OS benefits across PD-L1 subsets.
2. 💊 For Bevacizumab-Ineligible Patients: Pembrolizumab with a chemotherapy doublet remains a strong option.
3. 🩺 Affordability Considerations: Bevacizumab with a chemotherapy doublet is a cost-effective alternative.
