Based on the results of the phase III BEATcc trial, there is no longer doubt that immune checkpoint inhibitors have transformed the treatment landscape in cervical cancer—and there is no place for “skeptics” of this approach, according to Bradley J. Monk, MD, FACS, FACOG, Director and Principal Investigator of HonorHealth Research Institute and Professor at Creighton University and University of Arizona Phoenix. “This is a positive study…and good news for patients,” the invited discussant said.

Bradley J. Monk, MD, FACS, FACOG

The BEATcc trial joins KEYNOTE-826 in establishing the power of immune checkpoint blockade as a first-line treatment in advanced cervical cancer. KEYNOTE-826 demonstrated that adding pembrolizumab to chemotherapy—especially when bevacizumab is given (it was optional in the study)—significantly improved survival. In the bevacizumab cohort, the addition of pembrolizumab led to a median overall survival of 37.6 months, vs 22.5 months with chemotherapy plus bevacizumab alone (hazard ratio = 0.61).

“BEATcc confirms the importance of bevacizumab in first-line cervical cancer, as shown in GOG 240, and it confirms the results of KEYNOTE-826,” Dr. Monk stated. “KEYNOTE-826’s final overall survival analysis is practice-changing,” he added.

Pembrolizumab and atezolizumab both led to overall survival improvements, with nearly identical outcomes in the control arms and similar hazard ratios. “These trials cannot be compared, as they have similarities and also differences,” Dr. Monk cautioned. Clinicians with access to both checkpoint inhibitors “have decisions to make,” he acknowledged. “Clinical use should be based on benefit, safety, and reimbursement policies.”

DISCLOSURE: Dr. Monk reported financial relationships with Acrivon, Adaptimmune, Agenus, Akeso Bio, Amgen, Aravive, AstraZeneca, Bayer, Clovis, Easai, Elevar, EMD Merck, Genmab/Seagen, GOG Foundation, Gradalis, Heng Rui, ImmunoGen, Karyopharm, Iovance, Laekna Health Care, Merck, Mersana, Myriad Genetics, Novartis, Novocure, OncoC4, Panavance, Pieris, Pfizer, Puma Biotechnology, Regeneron, Roche/Genentech, Sorrento, Tesaro/GSK, US Oncology Research, VBL, Verastem, and Zentalis Pharmaceuticals.