PD-1 blockade + chemoradiation (locally advanced cervical cancer)

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.