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Cervical Cancer · Medical · First-line persistent, recurrent or metastatic cervical cancer

KEYNOTE-826

Does pembrolizumab added to platinum chemotherapy with or without bevacizumab improve outcomes in advanced cervical cancer?

Trial design and population

Population / eligibility
617 patients with persistent, recurrent or metastatic cervical cancer.
Treatment vs comparator
Pembrolizumab 200 mg IV q3 weeks + paclitaxel and cisplatin/carboplatin, with or without bevacizumab, vs placebo plus the same chemotherapy.
Sample size
617 (reported trial population)
Featured endpoint
Median OS, CPS ≥1 · final OS analysis

Registry: undefined.

Key results

PD-L1 CPS ≥1: median OS 28.6 vs 16.5 months (HR 0.60, 95% CI 0.49–0.74). All-comer median OS 26.4 vs 16.8 months (HR 0.63, 95% CI 0.52–0.77).

Outcome visualization

Median OS, CPS ≥1 · final OS analysis · 28.6

Placebo + chemotherapy
16.5
Grade ≥3 adverse events 82.4% vs 75.4%. Cytopenias, neuropathy and fatigue overlap with immune toxicity; bevacizumab adds hypertension, thromboembolism, bleeding and fistula risks.
Pembrolizumab + chemotherapy

Bars scale to the larger reported value. Median survival values are time-to-event summaries, not fixed-time absolute event risks.

Absolute Effect

Endpoint/time horizon: Median OS, CPS ≥1 · final OS analysis · 28.6.

NNT: Not calculated from median survival or hazard ratios; calculate only from defensible fixed-time absolute risks.

NNH: Not calculated unless a fixed-time excess-harm risk difference is available. Check CPS, histology, autoimmune history and bevacizumab suitability. Median survival differences are not fixed-time risks and cannot be converted into NNT.

Safety, burden and QoL

Check CPS, histology, autoimmune history and bevacizumab suitability. Median survival differences are not fixed-time risks and cannot be converted into NNT.

QoL and discontinuation percentages are not asserted where not verified from the full primary report; complete source-table audit remains a QC item.

Subgroups, maturity and limitations

https://pubmed.ncbi.nlm.nih.gov/35139273/

Distinguish prespecified from exploratory subgroups, immature from mature endpoints, and superiority from non-inferiority. Historical comparators may not represent all current treatment sequences.

Current-practice context · 21 October 2026

Verify current guidelines, regulatory status, biomarker requirements, prior treatment, comorbidities and patient goals before applying these historical trial results. Clinical freshness and full QoL/toxicity source review remain open where noted.

Primary and authoritative sources