Dr. Monk on Transformative KEYNOTE-826 Data in Frontline Cervical Cancer

Bradley J. Monk, MD, FACS, FACOG, professor, Division of Gynecologic Oncology, Arizona Oncology (US Oncology Network), University of Arizona College of Medicine, Creighton University School of Medicine at St. Joseph’s Hospital, medical director, Gynecologic Program, US Oncology Research Network, and co-director, GOG Partners, discusses outcomes with pembrolizumab (Keytruda) plus chemotherapy in patients with recurrent or metastatic cervical cancer, as reported in the phase 3 KEYNOTE-826 trial (NCT03635567).

KEYNOTE-826 has evolved the treatment paradigm for front-line cervical cancer by adding pembrolizumab to standard-of-care bevacizumab (Avastin) chemotherapy, according to Monk. The study enrolled 617 patients and met all of its therapeutic end points at the time of the first interim analysis, Monk continues.

Patients in the control arm in this study, bevacizumab alone, experienced similar response rates as have been observed in previous studies, at approximately 48% to 50%, Monk explains. The addition of pembrolizumab improved response rates, increasing them to 66%. Although these data are generating excitement, the goal is tumor control, Monk says. The hazard ratio for progression-free survival was 0.65. 

What is most important in this research is survival and tolerability, and no new safety signals were observed, according to Monk. The results showed more tumor shrinkage, longer tumor control, longer survival, and better patient-reported outcomes, which transforms the standard of care in a meaningful way, Monk says. The median overall survival in the investigative arm has not been met, and at 2 years, 33% more patients were alive. This treatment regimen will likely acquire global regulatory approval and broad reimbursement, Monk concludes.