Recurrent or metastatic cervical cancer: lines of therapy

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5 standard-of-care settings across 4 lines and 2 biomarker subgroups. Rows come from the cancer page's standard of care; the grid places each on its line and subgroup.

Line	All comers	HER2
Advanced, first line	1	·
Second line	2	·
Third line and beyond	1	·
Other settings	·	1

Advanced, first line

Subgroup	Setting	Approach	Products and trials	Guideline	Evidence
All comers	First line	Pembrolizumab with cisplatin or carboplatin, paclitaxel and, when safe, bevacizumab (KEYNOTE-826); atezolizumab with chemotherapy and bevacizumab (BEATcc) or cadonilimab with chemotherapy (COMPASSION-16, China) as alternatives.	PembrolizumabKEYNOTE-826CisplatinCarboplatinPaclitaxel / nab-paclitaxelBevacizumabAtezolizumabBEATcc / ENGOT-Cx10 / GOG-3030CadonilimabCOMPASSION-16 / AK104-303PD-L1		98

Second line

Subgroup	Setting	Approach	Products and trials	Guideline	Evidence
All comers	Second line after platinum	Tisotumab vedotin (innovaTV 301) with prophylactic eye care; cemiplimab (EMPOWER-Cervical 1) if no prior immunotherapy.	Tisotumab vedotininnovaTV 301 / ENGOT-cx12 / GOG-3057CemiplimabEMPOWER-Cervical 1 / GOG-3016 / ENGOT-cx9Antibody-drug conjugate (ADC)		98
All comers	Isolated pelvic recurrence after radiotherapy	Pelvic exenteration in fit patients without sidewall fixation.	Robotic & minimally invasive surgeryIMRT / IGRT (modern external beam)		93

Third line and beyond

Subgroup	Setting	Approach	Products and trials	Guideline	Evidence
All comers	Later lines	Single-agent chemotherapy (topotecan, gemcitabine, pemetrexed, vinorelbine) with modest response; clinical trials of new antibody-drug conjugates and cell therapy preferred.	TopotecanGemcitabineSacituzumab tirumotecanLifileucel		96

Other settings

Subgroup	Setting	Approach	Products and trials	Guideline	Evidence
HER2	HER2-expressing disease	Trastuzumab deruxtecan after prior therapy (DESTINY-PanTumor02).	Trastuzumab deruxtecanDESTINY-PanTumor02HER2		97

Sequence and caution pairings

CautionApproved

Caution: DXd ADC + agents with pneumonitis risk

Enhertu and its DXd cousins can inflame the lungs; combining them with immunotherapy, radiation, or mTOR inhibitors stacks that risk.

Lines and subgroups are parsed from the setting text of each standard-of-care row and can misclassify an unusual phrasing; the row’s own setting is always shown. Guideline chips reflect the NCCN category and ESMO-MCBS grade recorded on the cancer page, checked on its stated date. Not medical advice.