Immunotherapy added to first-line standard therapy significantly improves survival in metastatic or recurrent cervical cancer

Immunotherapy added to first-line standard therapy significantly improves survival in metastatic or recurrent cervical cancer

• Published in The Lancet, results of the randomized phase III BEATcc academic trial (ENGOT-Cx10/GEICO 68-C/JGOG1084/GOG-3030) show that adding immune checkpoint inhibitor atezolizumab to standard of care with bevacizumab and chemotherapy significantly improves progression-free survival and overall survival in patients with metastatic or recurrent cervical cancer who are not candidates for curative-intent surgery and/or radiotherapy.
• This study is the first to add a PD-L1 inhibitor to standard of care with bevacizumab plus platinum-based doublet chemotherapy in this setting.
• Presented by VHIO’s Ana Oaknin, Principal Investigator and first author of this international study, as an ESMO Virtual Plenary, data show a median overall survival of 32.1 months in patients who received atezolizumab plus standard of care vs. 22.8 months in patients treated with bevacizumab combined with chemotherapy alone.

Patients with metastatic or recurrent cervical cancer not amenable to curative surgery and/or radiotherapy have a poor prognosis with limited treatment options. First-line treatment in this setting consists of combination cisplatin/paclitaxel chemotherapy plus antiangiogenic agent bevacizumab. This therapeutic strategy was approved based on the results of the previous phase III Gynecologic Oncology Group (GOG) 240 trial that showed a median overall survival (OS) of 17 months and progression-free survival (PFS) of 8.2 months.

Directed by Ana Oaknin, Principal Investigator of the Vall d’Hebron Institute of Oncology’s (VHIO) Gynecological Malignancies Group, Medical Oncologist at the Vall d’Hebron University Hospital (HUVH) and an investigator of the Spanish Ovarian Cancer Research Group (GEICO), the open-label phase III BEATcc academic trial (ENGOT-Cx10/GEICO 68-C/JGOG1084/GOG-3030) was designed to evaluate the addition of PD-L1 checkpoint inhibitor atezolizumab to standard of care with first-line chemotherapy plus bevacizumab—irrespective of PD-L1 status­—versus standard therapy alone.

This international study, results of which have now published in The Lancet, included 410 previously untreated patients with metastatic (stage IVB) or recurrent cervical cancer not amenable to curative surgery/radiation who were randomized 1:1 to standard therapy or the combination with the addition of atezolizumab.

“At a median follow-up of 35 months, median overall survival in patients treated with the combination of atezolizumab plus standard therapy was 32.1 months versus 22.8 months in the control arm. This significant improvement is unprecedented in this setting,” says Ana Oaknin, lead author and Principal Investigator of this present study.

She continues, “While the approval of the current standard of care was based on the results of the previous GOG 240 study, the two-year survival rate was less than 40%. Interim OS results of this present study show a two-year survival rate of 60% in patients who received atezolizumab plus bevacizumab and the chemotherapy doublet.”

The BEATcc study investigators also observed significantly improved PFS results. Median PFS was 13.7 months in patients treated with the experimental combination and 10.4 months in the control arm.

“In view of the impact on overall survival, and upon evaluation by the different regulatory authorities and healthcare reimbursement systems, the addition of atezolizumab to standard therapy with bevacizumab and chemotherapy should be considered as a new first line treatment option for patients with metastatic or recurrent cervical cancer,” concludes Oaknin.

Results of the BEATcc study were initially selected as late-breaking data at the 2023 Congress of the European Society for Medical Oncology (ESMO), 20-24 October in Madrid, and subsequently presented by Ana Oaknin as an ESMO Virtual Plenary. 

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About VHIO

The Vall d’Hebron Institute of Oncology (VHIO), established in 2006 and located within the Vall d’Hebron Campus, is a reference comprehensive cancer center for personalized medicine in oncology. Through our purely translational and multidisciplinary research model, we aim to improve the prevention, early diagnosis and treatment of cancer by transforming the latest scientific discoveries made in the laboratory into early phase clinical trials for the development of more effective therapies to improve the quality of life and survival  of cancer patients.

VHIO forms part of the CERCA – Research Centres of Catalonia system and is accredited as a Severo Ochoa Center of Excellence.

Research at VHIO would not be possible without the support received from our patrons - Generalitat de Catalunya, Fundació Privada CELLEX, "La Caixa" Foundation, Fundación FERO, and the Fundación BBVA, the public funding it receives as well as the generous support from institutional supporters, private institutions, companies, associations, societies, and individual donors. Only with such continued support will VHIO continue to advance personalized and targeted therapies against cancer.