Incorporation of Immunotherapy in the Recurrent or Metastatic Setting for Patients With Cervical Cancer

At the 2024 Great Debates and Updates in Women’s Oncology meeting in New York, New York, Oladapo Yeku, MD, PhD, FACP, Massachusetts General Hospital, Boston, Massachusetts, participated in a debate arguing for the incorporation of immunotherapy for patients with cervical cancer in the recurrent or metastatic setting, but highlights that choices may differ in clinical practice.

Transcript:

Hi, my name is Dr. Oladapo Yeku. I'm an assistant professor at Harvard Medical School and a director of translational research at the Massachusetts General Hospital. I'm here today with Great Debates and Updates in Women's Oncology. The topic of discussion for the debate this afternoon was the incorporation of immunotherapy for cervical cancer, whether in the upfront setting for locally advanced disease or in the recurrent or metastatic setting.

The argument that I supported was the use of immunotherapy in the recurrent setting. With the recent FDA approval for both indications, the question of timing and sequencing is very pertinent and has direct impact on patient lives. However, we tend to think of it as a marathon and not necessarily a sprint.

And for this reason, women who are not cured in that immediate setting where they receive their immunotherapy upfront face a potentially important question in that recurrent setting. Do they re-add immunotherapy with platinum-based chemotherapy, or do they use chemotherapy alone? 

I would argue that because the magnitude of benefit in that recurrent setting with the incorporation of immunotherapy is significant and life-changing, we should be reserving immunotherapy for patients who recur after definitive disease treatment. 

That said, in clinical practice, everything involves an informed decision with the patient, a discussion of the pros and the cons. We all hope for cure. And for that reason, it would be reasonable to incorporate immunotherapy in the upfront setting for the approved indication for women with stage III/stage IV disease. Thank you.

Source: 

 
Yeku O. Immune Checkpoint Inhibitors + Chemo Should Be Used in the First-Line Metastatic Setting in Cervical Cancer. Presented at Great Debates and Updates in Women’s Oncology; May 3-4, 2024; New York, NY.