# KEYNOTE-826: pembrolizumab plus chemotherapy with or without bevacizumab for persistent, recurrent or metastatic cervical cancer

Source: https://onco.cc/key-papers/paper-keynote-826-nejm-2021/  
OnCo record `paper-keynote-826-nejm-2021` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Adding pembrolizumab to first-line chemotherapy, with or without bevacizumab, lengthened survival in advanced cervical cancer, the first improvement in the disease since bevacizumab was added seven years earlier.

## Summary

Phase 3 placebo-controlled trial of 617 patients with persistent, recurrent or metastatic cervical cancer randomised to pembrolizumab or placebo with platinum-paclitaxel chemotherapy, with bevacizumab at investigator discretion.

In the PD-L1 combined positive score 1 or more population, median overall survival was not reached versus 16.3 months at the first analysis (hazard ratio 0.64) and 28.6 versus 16.5 months on update; progression-free survival was 10.4 versus 8.2 months.

## Fields

- Kind: Key paper
- Last checked: 2026-09-17
- Journal: New England Journal of Medicine
- Year: 2021
- DOI: 10.1056/NEJMoa2112435
- Authors: Colombo N, Dubot C, Lorusso D, et al.
- Findings: Combined positive score 1 or more: overall survival hazard ratio 0.64; updated median 28.6 vs 16.5 months.; Median progression-free survival 10.4 vs 8.2 months.
- What it means: Pembrolizumab plus chemotherapy with bevacizumab is the first-line standard for recurrent or metastatic cervical cancer with PD-L1 expression, which covers about nine in ten patients.
- Caveats: Benefit in PD-L1-negative tumours was uncertain.; Bevacizumab use was not randomised.

## Sources

- N Engl J Med 2021: https://doi.org/10.1056/NEJMoa2112435
- PubMed: https://pubmed.ncbi.nlm.nih.gov/34534429/

## Connected records

- cancers: [Recurrent or metastatic cervical cancer](https://onco.cc/cancers/recurrent-metastatic-cervical-cancer/)
- drugs: [Pembrolizumab](https://onco.cc/drugs/pembrolizumab/)
- trials: [KEYNOTE-826](https://onco.cc/trials/keynote-826/)
- journals: [New England Journal of Medicine](https://onco.cc/journals/nejm/)

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