{"entity":{"id":"io-plus-crt-cervical","kind":"pairing","name":"PD-1 blockade + chemoradiation (locally advanced cervical cancer)","aka":[],"tldr":"Adding pembrolizumab to curative chemoradiation improved survival in high-risk locally advanced cervical cancer (KEYNOTE-A18); durvalumab in a broader population did not (CALLA).","summary":"Adding pembrolizumab to curative chemoradiation, including brachytherapy, is a combination pairing for high-risk locally advanced cervical cancer that improved overall survival in the phase 3 KEYNOTE-A18 / ENGOT-cx11 / GOG-3047 trial and gained FDA approval for FIGO stage III to IVA disease in 2024. The rationale is that radiation releases tumour antigen and upregulates PD-L1, making the tumour immunogenic, and PD-1 blockade given concurrently and then as maintenance sustains the response. The sister trial CALLA, which used durvalumab in a broader population, was negative, possibly because it enrolled lower-risk patients and used a different drug. Cost limits use of the approach outside high-income countries, and it belongs to the wider family of radiotherapy plus immunotherapy pairings.","asOf":"2026-09-07","links":[{"label":"ClinicalTrials.gov NCT04221945: KEYNOTE-A18 / ENGOT-cx11 / GOG-3047","url":"https://clinicaltrials.gov/study/NCT04221945"}],"tags":[],"related":["radiation-plus-io"],"cancers":["cervical"],"sections":[],"technologies":[],"targets":[],"drugs":["pembrolizumab"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":["keynote-a18"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"a":"pembrolizumab","b":"brachytherapy","rationale":"Radiation-induced antigen release and PD-L1 upregulation make the tumour immunogenic; concurrent and maintenance PD-1 blockade sustains the response.","evidence":"Phase 3 OS benefit (KEYNOTE-A18); negative sister trial (CALLA).","pairingType":"combination"},"route":"/pairings/io-plus-crt-cervical/","neighbours":{"pairing":[{"id":"radiation-plus-io","kind":"pairing","name":"Radiotherapy + immunotherapy","route":"/pairings/radiation-plus-io/"}],"cancer":[{"id":"cervical","kind":"cancer","name":"Cervical cancer","route":"/cancers/cervical/"},{"id":"locally-advanced-cervical-cancer","kind":"cancer","name":"Locally advanced cervical cancer","route":"/cancers/locally-advanced-cervical-cancer/"}],"drug":[{"id":"pembrolizumab","kind":"drug","name":"Pembrolizumab","route":"/drugs/pembrolizumab/"}],"trial":[{"id":"keynote-a18","kind":"trial","name":"KEYNOTE-A18 / ENGOT-cx11 / GOG-3047","route":"/trials/keynote-a18/"}],"technology":[{"id":"brachytherapy","kind":"technology","name":"Brachytherapy","route":"/technologies/brachytherapy/"}]}}