“Cervical cancer is changing – and immunotherapy is driving that transformation… Our goal is not just to extend survival, but to move toward curing advanced disease”
#ASCO25 was very exciting for gynecological oncology, particularly in cervical cancer, where immunotherapy continues to reshape our approach. It was a privilege to speak with touchONCOLOGY Editorial Board Member Dr Domenica Lorusso (Director of Gynaecological Oncology Unit at Humanitas Hospital San Pio X, Milan; and Full Professor of Obstetrics and Gynaecology, Humanitas University, Rozzano (MI), Milan, Italy). Here, she summarizes the key points from her late-breaking presentation on new advances in cervical cancer. From later-line therapies to combinations in locally advanced disease, we’re seeing real momentum. At the same time, antibody–drug conjugates and novel targets are opening the door to new treatment paradigms.
Immunotherapy reshapes the cervical cancer treatment landscape
#ASCO25 was particularly meaningful for gynecological cancers. I had the privilege of presenting on the current state of treatment in cervical cancer – a field that has undergone a significant shift in recent years, largely due to the introduction of immunotherapy.
Cervical cancer is one of approximately 5% of human tumours associated with a viral etiology, specifically HPV infection. In the presence of infection, immunotherapy tends to be most effective.
Pembrolizumab: KEYNOTE-826 & KEYNOTE-A18
The first major advance came with pembrolizumab in the later-line setting. It received FDA approval in 2018 based on a single-arm trial that reported a 70% overall response rate in PD-L1–positive patients. This was a key milestone in recognizing the potential of immune checkpoint inhibitors in cervical cancer. The KEYNOTE-826 trial evaluated pembrolizumab in combination with paclitaxel and carboplatin – with or without bevacizumab – as a first-line treatment. This regimen led to improvements in both PFS and OS, with a median OS of approximately 24 months. While this represents an extension of life, it remains a limited gain. If we aim to truly alter the trajectory of disease and improve cure rates, immunotherapy must be introduced at even earlier stages.
The KEYNOTE-A18 (Abstract LBA5504) was designed to test this hypothesis. It evaluated pembrolizumab in combination with concurrent chemoradiation in patients with locally advanced cervical cancer. Final overall survival data presented at ASCO 2025 confirmed improvements in both PFS and OS in high-risk patients. As a result, pembrolizumab has now been approved in combination with chemoradiation for stage III and IV disease, and also for selected patients with stage IB2 to IIB node-positive disease. These approvals are reflected in the most recent NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®), establishing a new standard of care.
Cemiplimab: OS and PFS gains over chemotherapy
More recently, cemiplimab demonstrated superiority over chemotherapy in Europe, with improvements seen in both progression-free survival (PFS) and overall survival (OS). This further validated the use of immunotherapy as a core treatment strategy in advanced cervical cancer.
Future promise with antibody–drug conjugates
Looking to the future, antibody–drug conjugates (ADCs) represent a potential avenue for further therapeutic development in cervical cancer. Tisotumab vedotin is already approved, with data showing superior PFS and OS compared to chemotherapy. In the United States, trastuzumab deruxtecan has been approved for HER2-positive disease, initially for HER2 3+ tumours and more recently for HER2 2+ tumours, as per updated NCCN guidance. Unfortunately, this option is not yet available in Europe. Several other ADCs are currently in development, targeting novel antigens such as B7-H3, nectin-4 and Trop-2. These agents suggest that the next wave of treatment innovation for cervical cancer may lie in more precise, biomarker-driven approaches.
View full #ASCO25 coverage here!
Disclosures: Domenica Lorusso is a consultant for MSD, GSK, Novartis; she has received grant/research support from Astra Zeneca, Clovis Oncology, Pharmaand Genmab, GSK, immunogen, Incyte, MSD, Novartis, Pharmamar, Roche, Seagen, alkermes and corcept; she is a member of the Advisory Board for Astra Zeneca, clovis oncology, corcept, daiichi sankyo, genmab, gsk, immunogen, msd, abbvie, novartis oncoinvest, novocure, seagen and sutro; she is a Speaker’s Bureau participant with Astra Zeneca, clovis oncology, corcept, daiichi sankyo, genmab, gsk, immunogen, msd, abbvie, novartis oncoinvest, novocure, seagen and sutro.
This content has been developed independently by Touch Medical Media for touchONCOLOGY. It is not affiliated with the American Society of Clinical Oncology (ASCO). Views expressed are the speaker’s own and do not necessarily reflect the views of Touch Medical Media.
Interviewer/Editor: Sophie Nickelson
Cite: #ASCO25: Domenica Lorusso on a new era for cervical cancer. touchONCOLOGY. June 24th, 2025.
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