Pembrolizumab for advanced cervical cancer: safety and efficacy

ABSTRACT

Introduction: Pembrolizumab is an immune checkpoint inhibitor with high specificity for binding to the programmed cell death 1 (PD-1) receptor. It has been approved by the FDA in patients with recurrent or metastatic cervical cancer with disease progression on or after chemotherapy whose tumors express the programmed cell death ligand 1 (PD-L1).

Areas covered: Clinical studies of pembrolizumab in cervical cancer were analyzed and discussed. Data were obtained by searching for English peer-reviewed articles on PubMed, clinical trials registered on clincaltrials.gov and related abstracts on the ASCO meeting library. The aim was to review the status of pembrolizumab, the published and ongoing trials, and its safety and efficacy.

Expert opinion: Pembrolizumab may ultimately represent a treatment of choice for advanced cervical cancer with PD-L1 expression, both in metastatic and recurrent setting. However, it is essential to better identify and characterize patients that will benefit the most.

KEYWORDS:

• metastatic
• recurrent
• cervical cancer
• pembrolizumab
• immunotherapy

Article highlights

• Pembrolizumab is a new therapeutic option in the cervical cancer armamentarium

• Pembrolizumab, alone or in combination with chemotherapy, is the subject of numerous ongoing studies

• There are several trials addressing the role of pembrolizumab in advanced, recurrent, and metastatic cervical cancer patients

• Results from KEYNOTE-028 (phase Ib trial) and KEYNOTE-158 trial (phase II trial) presented at The American Society of Clinical Oncology (ASCO) suggest that pembrolizumab has promising antitumor activity in patients with PD-L1 expression in advanced cervical cancer

• Two ongoing phase III trials are currently investigating the role of pembrolizumab in combination with chemoradiotherapy in locally advanced cancer (KEYNOTE-A18/ENGOT-cx11 trial) and in association with chemotherapy in persistent, recurrent or metastatic cancer (MK-3475-826/KEYNOTE-826 trial). The aim is to demonstrate an improved response to therapy with prolongation of survival.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

A peer reviewer on this manuscript has served as an investigator for the EMPOWER phase 3 randomized trial of anti-PD-1 cemiplimab for cervical cancer and the UC Irvine PI for Kenote-826. Peer reviewers on this manuscript have no other relevant financial relationships or otherwise to disclose.

Additional information

Funding

This paper received no funding.