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Keytruda boosts survival in advanced cervical cancer as first line therapy

Photo credit – Keytruda patient website, copyright Merck & Co., Inc

CANCER DIGEST – May 27, 2023 – Women with persistent, recurrent or cervical cancer that has spread to other tissues had improved overall survival and longer progression-free survival when pembrolizumab (Keytruda®) was added to chemotherapy, a new study shows.

The interim results of the international study called KEYNOTE-826 will be presented at the 2023 American Society of Clinical Oncology (ASCO) annual meeting taking place in Chicago June 2-6, 2023.

Led by Nicoletta Colombo, MD, PhD of the European Institute of Oncology in Milan, Italy, the study involves 617 patients at 149 cancer centers around the world whose cervical cancer is resistant to treatment, has recurred or has spread to other tissues making it untreatable with surgery or radiation.

At a median follow-up (half of the patients have been followed longer and half have been followed for less time) of 39 months, results showed that overall survival was 26.4 months for those given chemotherapy plus pembrolizumab vs.16.5 months for those treated with chemotherapy alone.

That worked out to a 37 percent lower risk of death for patients in the pembrolizumab groups. That lower risk of dying was tempered with higher side effects with 30.3 percent in the pembrolizumab group experiencing anemia compared to 27.8 percent of the chemo alone group. Similarly, the pembrolizumab-treated patients had higher rates of low white-blood cell counts (neutropenia) 12.4 percent vs. 9.7 percent.

“This study demonstrates that giving immunotherapy earlier provides a substantial overall survival benefit compared with the second-line setting," lead author Bradley Monk, MD, FACS, FACOG of Creighton University School of Medicine said in a press release. "Our results also show a survival benefit of pembrolizumab in patients who are not eligible for bevacizumab, offering a therapeutic option in this population of patients with a high unmet need.”

Bevacizumab (Avastin®) is an immune therapy that blocks blood vessel growth in some types of tumors. Bevacizumab injections are in a class of medications called antiangiogenic agents. They work by stopping the formation of blood vessels that bring oxygen and nutrients to tumors. This may slow the growth and spread of tumors.

According to background information in the press release, 16 percent of people with cervical cancer are diagnosed with metastatic disease. The five-year survival for such patients is around 17 percent. Worldwide it is the fourth most common cause of cancer death in women.

Pembrolizumab is currently FDA-approved for treatment of cervical cancer patients whose tumors produce higher levels of the PD-L1 protein. This study shows that the addition of pembrolizumab to chemotherapy could be effective as a first-line treatment option, regardless of PD-L1 status.

The study was funded by Merck & Co., Inc., which makes Keytruda®.

Source: ASCO press release

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