OnCo
cancersCancer

Cervical cancer

A cancer that could be eliminated by HPV vaccination and screening. For those who develop it, immunotherapy and a tissue-factor ADC have improved survival.

Cervical cancer is almost entirely caused by persistent infection with high-risk human papillomavirus, which makes it the one common cancer that could be eliminated: HPV vaccination prevents about 90% of cases, HPV screening finds the precancers that remain, and a minute of thermal ablation or a loop excision cures them. Around 660,000 women are diagnosed and 350,000 die each year, nine in ten of them in low- and middle-income countries where vaccination and screening have not reached. In Sweden, Scotland, and Australia, cohorts vaccinated at 12-13 show near-zero invasive cancer, and Australia expects to pass the WHO elimination threshold (4 per 100,000) around 2035.

For women who develop cancer, treatment depends on stage. Early disease is treated with open radical hysterectomy (minimally invasive surgery proved worse in the LACC trial) or, for the smallest tumours, fertility-sparing surgery, with sentinel node mapping under evaluation. Locally advanced disease is cured in roughly two-thirds by cisplatin chemoradiation with brachytherapy, and two 2023-24 trials improved on that standard for the first time since 1999: six weeks of induction carboplatin-paclitaxel (INTERLACE, 5-year OS 80% vs 72%) and pembrolizumab with chemoradiation (KEYNOTE-A18, 36-month OS 82.6% vs 74.8%). Metastatic or recurrent disease, once treated with chemotherapy alone, now has first-line chemotherapy plus a checkpoint inhibitor with or without bevacizumab (KEYNOTE-826, BEATcc, COMPASSION-16 in China), the tissue-factor ADC tisotumab vedotin in second line (innovaTV 301), and HER2-directed therapy for the minority with HER2-positive tumours.

What comes next is mostly delivery rather than discovery: single-dose HPV vaccination and self-sampled HPV testing to reach the 90-70-90 targets, screen-and-treat with portable ablation devices, AI-read colposcopy, and cheaper immunotherapy access. On the treatment side, HPV ctDNA to guide who needs maintenance therapy, TROP2 ADCs (sacituzumab tirumotecan), TIL therapy, and therapeutic HPV vaccines are in trials. The enduring problem is that the tools already exist and the women who die do not have them.

State of the art today

  • Near-elimination in vaccinated cohorts (Scotland, Sweden).
  • IO in locally advanced and metastatic disease.
  • Vaccinated cohorts in Sweden and Scotland show a ~90% to near-total reduction in invasive cervical cancer; single-dose schedules (97.5% efficacy in KEN SHE) make global coverage achievable.
  • HPV primary screening with self-sampling has replaced the Pap smear as the recommended test and reaches women who never attended clinics.
  • Two curative-intent advances in one year after 24 years of stasis: induction chemotherapy (INTERLACE, OS HR 0.60) and pembrolizumab with chemoradiation (KEYNOTE-A18, OS HR 0.67).
  • Surgical evidence now favours less: simple over radical hysterectomy for small tumours (SHAPE) and open over minimally invasive radical hysterectomy (LACC).
Show survival figures (2)

Averages across everyone diagnosed, often years ago. Your stage, subtype, age, fitness and the treatment you receive matter more than the average, and the numbers are improving quickly.

  • First-line chemo-immunotherapy roughly doubles median survival in metastatic disease compared with the pre-2014 era (KEYNOTE-826 26.4 months; BEATcc 32.1 months).
  • The first ADC with survival benefit in cervical cancer (tisotumab vedotin) and tumour-agnostic HER2 ADC access.
Who it affects
Show survival figures (2)

Averages across everyone diagnosed, often years ago. Your stage, subtype, age, fitness and the treatment you receive matter more than the average, and the numbers are improving quickly.

  • Cervical cancer causes ~660,000 cases and ~350,000 deaths per year.
  • It is the fourth most common cancer in women worldwide and the leading cancer killer of women in many sub-Saharan African countries.

Where the cases are

Cases by country · GLOBOCAN 2022
All countries →

Site: Cervix uteri. World: 662,301 new cases, 348,874 deaths.

#CountryNew casesDeaths
1China150,65955,694
2India127,52679,906
3Indonesia36,96420,708
4Brazil18,7159,905
5Russian Federation18,3697,903
6United States of America13,9205,932
7Nigeria13,6767,093
8Japan10,9583,864
9Tanzania, United Republic of10,8686,832
10South Africa10,5325,976

Standard of care

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Prevention

HPV vaccination age 9-14; HPV primary screening.

NCCN Guidelines: Cervical Cancer
HPV & HBV vaccination
Locally advanced

Cisplatin chemoradiation + brachytherapy + pembrolizumab.

NCCN Guidelines: Cervical Cancer
BrachytherapyIMRT / IGRT (modern external beam)Pembrolizumab
Recurrent/metastatic

Pembrolizumab-chemotherapy-bevacizumab; tisotumab vedotin.

ESMO-MCBS · 2 (innovaTV 204 tisotumab vedotin, single-a…
PembrolizumabTisotumab vedotin
Primary prevention

HPV vaccination of girls (and boys) at 9-14, one or two doses per WHO; catch-up to 26 (US label to 45). Reduces invasive cancer ~90% when given before exposure.

NCCN · Prevention guideline
HPV & HBV vaccinationNonavalent HPV vaccineKEN SHE (single-dose HPV vaccine)
Screening

HPV primary testing every 5 years from 25-30 (self-sampling accepted), or cytology every 3 years; VIA or HPV screen-and-treat in low-resource settings; WHO target 70% screened twice in a lifetime.

NCCN · USPSTF Grade A
HPV DNA testing and self-samplingThermal ablation and cryotherapy for cervical precancerColposcopy and excisional treatment (LEEP/LLETZ, cone)
Precancer (HSIL / CIN2-3, AIS)

Colposcopy-directed biopsy then LEEP/LLETZ or cone excision; thermal ablation or cryotherapy where eligible; HPV test of cure at 6-12 months.

NCCN · ASCCP 2019 risk-based management
Colposcopy and excisional treatment (LEEP/LLETZ, cone)Thermal ablation and cryotherapy for cervical precancerCervical precancer (CIN, HSIL/LSIL)
Stage IA1-IB1 (≤2 cm)

Simple hysterectomy is non-inferior to radical for low-risk IA2-IB1 ≤2 cm (SHAPE trial, 2024); cone or trachelectomy for fertility preservation; sentinel node mapping in trials (SENTICOL III).

NCCN · 2A
Robotic & minimally invasive surgerySentinel lymph node biopsySENTICOL III
Stage IB2-IIA (surgical candidates)

Open radical hysterectomy with pelvic lymphadenectomy (minimally invasive approach inferior in LACC); adjuvant radiation or chemoradiation for intermediate/high-risk pathology (Sedlis, Peters criteria).

NCCN · 1 (open approach)
LACC (Laparoscopic Approach to Cervical Cancer)Caution: minimally invasive radical hysterectomy for early cervical cancerIMRT / IGRT (modern external beam)Cisplatin
Locally advanced (IB3, IIB-IVA), standard

Weekly cisplatin 40 mg/m² with external-beam IMRT/IGRT followed by image-guided brachytherapy to ≥85 Gy EQD2, completed within 56 days.

NCCN · 1ESMO-MCBS · A
CisplatinIMRT / IGRT (modern external beam)Brachytherapy
Locally advanced, high risk (node-positive IB2-IIB, III-IVA)

Add pembrolizumab during chemoradiation and for 15 maintenance cycles (KEYNOTE-A18, approved 2024 for FIGO III-IVA), or induction carboplatin-paclitaxel weekly × 6 before chemoradiation (INTERLACE). Adjuvant chemotherapy after chemoradiation is not recommended (OUTBACK).

NCCN · 1 (pembrolizumab); 2A (induction)ESMO-MCBS · A (KEYNOTE-A18)
KEYNOTE-A18 / ENGOT-cx11 / GOG-3047PembrolizumabINTERLACEInduction chemotherapy → chemoradiation (locally advanced cervical cancer)PD-1 blockade + chemoradiation (locally advanced cervical cancer)OUTBACK / ANZGOG 0902 / GOG-0274
Persistent, recurrent, or metastatic, first line

Pembrolizumab + cisplatin/carboplatin-paclitaxel ± bevacizumab (KEYNOTE-826, CPS ≥1 in the US); atezolizumab + chemotherapy + bevacizumab (BEATcc, region-dependent); cadonilimab + chemotherapy in China (COMPASSION-16).

NCCN · 1ESMO-MCBS · 4
KEYNOTE-826PembrolizumabBevacizumabBEATcc / ENGOT-Cx10 / GOG-3030AtezolizumabCOMPASSION-16 / AK104-303Cadonilimab
Second line and beyond

Tisotumab vedotin (innovaTV 301, OS benefit); cemiplimab if immunotherapy-naive (EU); T-DXd for HER2 IHC 3+; pembrolizumab for MSI-H/TMB-high; single-agent chemotherapy; trials of sac-TMT and TIL therapy.

NCCN · 1 (tisotumab)
Tisotumab vedotininnovaTV 301 / ENGOT-cx12 / GOG-3057CemiplimabEMPOWER-Cervical 1 / GOG-3016 / ENGOT-cx9Trastuzumab deruxtecanDESTINY-PanTumor02Sacituzumab tirumotecanLifileucel
Pelvic recurrence after radiation

Pelvic exenteration in selected patients with central recurrence; re-irradiation with brachytherapy or proton therapy in specialised centres.

NCCN · 2A
Robotic & minimally invasive surgeryBrachytherapyProton therapy

Subtypes & biomarkers

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Subtypes
Biomarkers clinicians test
  • HPV type
  • PD-L1 CPS
  • Tissue factor (not required)
  • High-risk HPV type (16, 18, others) and HPV status (HPV-independent tumours behave worse)
  • PD-L1 CPS (≥1 for pembrolizumab in recurrent disease; not required for KEYNOTE-A18)
  • p16 IHC (HPV surrogate)
  • HER2 (IHC 3+ for T-DXd; ~5-10%)
  • Tissue factor (not required for tisotumab)
  • Plasma HPV ctDNA (investigational monitoring)
  • FIGO 2018 stage incorporating imaging and nodal status
  • MSI/TMB (rare tumour-agnostic eligibility)

Target prevalence in this cancer

Target / alterationPrevalenceSource
Tissue factor
innovaTV did not select on TF
90-95%
Wikipedia

How common each drug target or alteration is in this cancer. Population-level and approximate; see the target page for detail. Full matrix.

History

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  1. 1943Pap smear introduced
  2. 1943Papanicolaou smear introduced

    Cytology screening cuts cervical cancer mortality by ~70% where implemented.

  3. 1983zur Hausen identifies HPV16 in cervical cancer

    HPV18 follows in 1984; Nobel Prize 2008.

    German Cancer Research Center (DKFZ)HPV & HBV vaccination
  4. 1999NCI clinical alert: cisplatin with radiation

    Five randomised trials show 30-50% mortality reduction; chemoradiation becomes standard for locally advanced disease.

    CisplatinIMRT / IGRT (modern external beam)
  5. 2006HPV vaccine approved
    HPV & HBV vaccination
  6. 2006First HPV vaccine (Gardasil) approved
    Nonavalent HPV vaccineHPV & HBV vaccination
  7. 2014Bevacizumab extends survival in advanced disease (GOG-0240); Gardasil 9 approved; HPV primary screening approved in the US
    BevacizumabNonavalent HPV vaccineHPV DNA testing and self-sampling
  8. 2018LACC: minimally invasive radical hysterectomy is inferior

    Practice reverses to open surgery within months.

    LACC (Laparoscopic Approach to Cervical Cancer)
  9. 2020WHO launches the Cervical Cancer Elimination Initiative (90-70-90 by 2030)

    Swedish registry study shows ~88% cancer reduction in women vaccinated before 17.

    HPV & HBV vaccinationHPV DNA testing and self-sampling
  10. 2021Tisotumab vedotin approved
    Tisotumab vedotin
  11. 2021KEYNOTE-826: first-line chemo-immunotherapy; tisotumab vedotin accelerated approval; EMPOWER-Cervical 1
    KEYNOTE-826Tisotumab vedotinEMPOWER-Cervical 1 / GOG-3016 / ENGOT-cx9
  12. 2022WHO endorses single-dose HPV vaccination (KEN SHE); OUTBACK negative
    KEN SHE (single-dose HPV vaccine)OUTBACK / ANZGOG 0902 / GOG-0274
  13. 2023KEYNOTE-A18 and INTERLACE positive; BEATcc and innovaTV 301 positive

    Four practice-changing phase 3 results presented at ESMO 2023.

    KEYNOTE-A18 / ENGOT-cx11 / GOG-3047INTERLACEBEATcc / ENGOT-Cx10 / GOG-3030innovaTV 301 / ENGOT-cx12 / GOG-3057
  14. 2024Pembrolizumab approved with chemoradiation (Jan); tisotumab full approval (Apr); FDA approves HPV self-collection (May); COMPASSION-16 published; SHAPE trial supports simple hysterectomy; Scotland reports zero cancers in fully vaccinated cohort
    KEYNOTE-A18 / ENGOT-cx11 / GOG-3047Tisotumab vedotinHPV DNA testing and self-samplingCOMPASSION-16 / AK104-303
  15. 2025At-home HPV self-test approved in the US; single-dose schedules adopted by 60+ countries
    HPV DNA testing and self-samplingNonavalent HPV vaccine
  16. 2026World Health Assembly calls for accountable elimination systems; sac-TMT and TIL trials in recurrent disease
    Sacituzumab tirumotecanLifileucel

Pipeline

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Under reviewADC
Sacituzumab tirumotecan
ApprovedTIL cell therapy
Lifileucel · Amtagvi
Not filedBispecific antibody (PD-1×CTLA-4)
Cadonilimab · Kaitanni
ApprovedADC
Trastuzumab deruxtecan · Enhertu
ApprovedProphylactic vaccine (virus-like particles)
Nonavalent HPV vaccine · Gardasil 9
SENTICOL IIIHPV DNA testing and self-samplingThermal ablation and cryotherapy for cervical precancerSingle-dose HPV vaccination plus HPV self-sampling to reach WHO elimination in low-income countriesHPV circulating tumour DNA to guide cervical cancer therapyMRD / molecular residual disease testingProton therapy

Open problems

  • Vaccine and screening access in LMICs.
  • Brachytherapy capacity.
  • Global HPV vaccination coverage of girls is around 27%; the disease is preventable and 350,000 women still die each year.
  • Screening reaches under 30% of women in most low- and middle-income countries; brachytherapy capacity is absent in much of Africa.
  • Pembrolizumab with chemoradiation costs far more than induction chemotherapy; how to combine or choose between KEYNOTE-A18 and INTERLACE is untested.
  • Recurrent disease after chemo-immunotherapy has few options; tisotumab adds two months of median survival.
  • HPV-independent (gastric-type) adenocarcinoma and neuroendocrine carcinoma have poor outcomes and no specific therapy.
  • Minimally invasive surgery's harm mechanism is unresolved; protective-technique trials (RACC, ROCC) are pending.
  • Therapeutic HPV vaccines (E6/E7-directed) have repeatedly shown immunogenicity without clear clinical benefit in invasive cancer.
  • Fertility preservation options for tumours over 2 cm remain limited.

Trials

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Recruiting now (live from ClinicalTrials.gov)

Recruiting trials near you · live from ClinicalTrials.gov
Cervical cancer
condition: Cervical cancer
Open on ClinicalTrials.gov →

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Landmark trials in OnCo

BEATcc / ENGOT-Cx10 / GOG-3030COMPASSION-16 / AK104-303DESTINY-PanTumor02EMPOWER-Cervical 1 / GOG-3016 / ENGOT-cx9innovaTV 301 / ENGOT-cx12 / GOG-3057INTERLACEKEN SHE (single-dose HPV vaccine)KEYNOTE-826KEYNOTE-A18 / ENGOT-cx11 / GOG-3047LACC (Laparoscopic Approach to Cervical Cancer)OUTBACK / ANZGOG 0902 / GOG-0274SENTICOL III

Expert centres

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Where the expertise is

Centres linked to this cancer in OnCo

Seeking a second opinion: ask your oncologist for a referral to a high-volume centre; most accept records and pathology by mail or telehealth. In the US, use the NCI's Find a Cancer Center tool or the nonprofit Cancer Commons, which navigates options for advanced cancers at no cost.

Questions to ask

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Bring to your appointment

Questions to ask your oncologist about Cervical cancer

Generated from this cancer's standard of care, biomarkers, and pipeline · 36 questions

Newly diagnosed

  1. What is my exact diagnosis, stage, and grade, and which tests established them?
    Why: Everything else follows from an accurate stage and subtype.
  2. Which biomarkers have been tested on my tumour (for example HPV type, PD-L1 CPS, Tissue factor, High-risk HPV typeand HPV status, PD-L1 CPS), and what were the results?
    Why: These results decide eligibility for targeted therapy, immunotherapy, and trials.
  3. Which subtype is my cancer, and does that change the recommended treatment?
    Why: Recognised subtypes for this cancer include Squamous cell carcinoma, Adenocarcinoma, Adenosquamous carcinoma.
  4. Is germline (inherited) genetic testing recommended for me or my family?
    Why: Inherited variants can change treatment and matter for relatives.

Prevention

  1. For my situation (prevention), which of the standard options do you recommend and why?
    Why: Guideline options include: HPV vaccination age 9-14; HPV primary screening.

Locally advanced

  1. For my situation (locally advanced), which of the standard options do you recommend and why?
    Why: Guideline options include: Cisplatin chemoradiation + brachytherapy + pembrolizumab.
  2. Am I a candidate for Pembrolizumab, and what side effects should I expect?
    Why: Knowing the expected toxicities helps you plan work, family, and supportive care.

Recurrent/metastatic

  1. For my situation (recurrent/metastatic), which of the standard options do you recommend and why?
    Why: Guideline options include: Pembrolizumab-chemotherapy-bevacizumab; tisotumab vedotin.
  2. Am I a candidate for Pembrolizumab, Tisotumab vedotin, and what side effects should I expect?
    Why: Knowing the expected toxicities helps you plan work, family, and supportive care.

Primary prevention

  1. For my situation (primary prevention), which of the standard options do you recommend and why?
    Why: Guideline options include: HPV vaccination of girls (and boys) at 9-14, one or two doses per WHO; catch-up to 26 (US label to 45). Reduces invasive cancer ~90% when given before exposure.
  2. Am I a candidate for Nonavalent HPV vaccine, and what side effects should I expect?
    Why: Knowing the expected toxicities helps you plan work, family, and supportive care.
  3. How do the results of KEN SHE (single-dose HPV vaccine) apply to someone like me?
    Why: Trial populations differ from individual patients; ask how closely you match.

Screening

  1. For my situation (screening), which of the standard options do you recommend and why?
    Why: Guideline options include: HPV primary testing every 5 years from 25-30 (self-sampling accepted), or cytology every 3 years; VIA or HPV screen-and-treat in low-resource settings; WHO target 70% screened twice in a lifetime.

Precancer (HSIL / CIN2-3, AIS)

  1. For my situation (precancer (hsil / cin2-3, ais)), which of the standard options do you recommend and why?
    Why: Guideline options include: Colposcopy-directed biopsy then LEEP/LLETZ or cone excision; thermal ablation or cryotherapy where eligible; HPV test of cure at 6-12 months.

Stage IA1-IB1 (≤2 cm)

  1. For my situation (stage ia1-ib1 (≤2 cm)), which of the standard options do you recommend and why?
    Why: Guideline options include: Simple hysterectomy is non-inferior to radical for low-risk IA2-IB1 ≤2 cm (SHAPE trial, 2024); cone or trachelectomy for fertility preservation; sentinel node mapping in trials (SENTICOL III).
  2. How do the results of SENTICOL III apply to someone like me?
    Why: Trial populations differ from individual patients; ask how closely you match.

Stage IB2-IIA (surgical candidates)

  1. For my situation (stage ib2-iia (surgical candidates)), which of the standard options do you recommend and why?
    Why: Guideline options include: Open radical hysterectomy with pelvic lymphadenectomy (minimally invasive approach inferior in LACC); adjuvant radiation or chemoradiation for intermediate/high-risk pathology (Sedlis, Peters criteria).
  2. Am I a candidate for Cisplatin, and what side effects should I expect?
    Why: Knowing the expected toxicities helps you plan work, family, and supportive care.
  3. How do the results of LACC (Laparoscopic Approach to Cervical Cancer) apply to someone like me?
    Why: Trial populations differ from individual patients; ask how closely you match.

Locally advanced (IB3, IIB-IVA), standard

  1. For my situation (locally advanced (ib3, iib-iva), standard), which of the standard options do you recommend and why?
    Why: Guideline options include: Weekly cisplatin 40 mg/m² with external-beam IMRT/IGRT followed by image-guided brachytherapy to ≥85 Gy EQD2, completed within 56 days.
  2. Am I a candidate for Cisplatin, and what side effects should I expect?
    Why: Knowing the expected toxicities helps you plan work, family, and supportive care.

Locally advanced, high risk (node-positive IB2-IIB, III-IVA)

  1. For my situation (locally advanced, high risk (node-positive ib2-iib, iii-iva)), which of the standard options do you recommend and why?
    Why: Guideline options include: Add pembrolizumab during chemoradiation and for 15 maintenance cycles (KEYNOTE-A18, approved 2024 for FIGO III-IVA), or induction carboplatin-paclitaxel weekly × 6 before chemoradiation (INTERLACE). Adjuvant chemotherapy after chemoradiation is not recommended (OUTBACK).
  2. Am I a candidate for Pembrolizumab, and what side effects should I expect?
    Why: Knowing the expected toxicities helps you plan work, family, and supportive care.
  3. How do the results of KEYNOTE-A18 / ENGOT-cx11 / GOG-3047 and INTERLACE apply to someone like me?
    Why: Trial populations differ from individual patients; ask how closely you match.

Persistent, recurrent, or metastatic, first line

  1. For my situation (persistent, recurrent, or metastatic, first line), which of the standard options do you recommend and why?
    Why: Guideline options include: Pembrolizumab + cisplatin/carboplatin-paclitaxel ± bevacizumab (KEYNOTE-826, CPS ≥1 in the US); atezolizumab + chemotherapy + bevacizumab (BEATcc, region-dependent); cadonilimab + chemotherapy in China (COMPASSION-16).
  2. Am I a candidate for Pembrolizumab, Bevacizumab, Atezolizumab or related drugs, and what side effects should I expect?
    Why: Knowing the expected toxicities helps you plan work, family, and supportive care.
  3. How do the results of KEYNOTE-826 and BEATcc / ENGOT-Cx10 / GOG-3030 apply to someone like me?
    Why: Trial populations differ from individual patients; ask how closely you match.

Second line and beyond

  1. For my situation (second line and beyond), which of the standard options do you recommend and why?
    Why: Guideline options include: Tisotumab vedotin (innovaTV 301, OS benefit); cemiplimab if immunotherapy-naive (EU); T-DXd for HER2 IHC 3+; pembrolizumab for MSI-H/TMB-high; single-agent chemotherapy; trials of sac-TMT and TIL therapy.
  2. Am I a candidate for Tisotumab vedotin, Cemiplimab, Trastuzumab deruxtecan or related drugs, and what side effects should I expect?
    Why: Knowing the expected toxicities helps you plan work, family, and supportive care.
  3. How do the results of innovaTV 301 / ENGOT-cx12 / GOG-3057 and EMPOWER-Cervical 1 / GOG-3016 / ENGOT-cx9 apply to someone like me?
    Why: Trial populations differ from individual patients; ask how closely you match.

Pelvic recurrence after radiation

  1. For my situation (pelvic recurrence after radiation), which of the standard options do you recommend and why?
    Why: Guideline options include: Pelvic exenteration in selected patients with central recurrence; re-irradiation with brachytherapy or proton therapy in specialised centres.

Any stage

  1. Are there clinical trials I could join, for example of Sacituzumab tirumotecan, Lifileucel, Cadonilimab, Trastuzumab deruxtecan?
    Why: Trials are how the next standard of care is set; asking early keeps options open.
  2. Would a second opinion at a high-volume centre change anything, and can you help arrange it?
    Why: Rare or high-stakes decisions benefit from a centre that treats many similar patients.
  3. What supportive care (symptom control, nutrition, exercise, mental health, financial help) is available from the start?
    Why: Supportive care improves quality of life and helps patients complete treatment.
  4. I read that “Vaccine and screening access in LMICs”. How does that affect my plan?
    Why: Open problems are where trials and second opinions matter most.
  5. I read that “Brachytherapy capacity”. How does that affect my plan?
    Why: Open problems are where trials and second opinions matter most.

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Everything relevant

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Direct links plus the targets, companies, and technologies of this cancer's products.

technologies

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Anti-angiogenic therapyAntibody-drug conjugate (ADC)Bispecific antibodiesBrachytherapyColposcopy and excisional treatment (LEEP/LLETZ, cone)Cytotoxic chemotherapyGlobal oncology and access in low- and middle-income countriesHPV & HBV vaccinationHPV DNA testing and self-samplingHyperthermiaImmune checkpoint inhibitorsIMRT / IGRT (modern external beam)Liquid biopsy (ctDNA)Monoclonal antibodiesMRD / molecular residual disease testingOncofertility and fertility preservationPlatinum agentsProton therapyRobotic & minimally invasive surgerySentinel lymph node biopsySmoking cessation in cancer patientsThermal ablation and cryotherapy for cervical precancerTIL therapyTopoisomerase-I inhibitors (and ADC payloads)

targets

7
CTLA-4HER2PD-1PD-L1Tissue factorTROP2VEGF / VEGFR

drugs

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ApprovedMonoclonal antibody (anti-PD-L1)
Atezolizumab · Tecentriq / Tecentriq Hybreza (SC)
ApprovedMonoclonal antibody (anti-VEGF)
Bevacizumab · Avastin (and biosimilars)
Not filedBispecific antibody (PD-1×CTLA-4)
Cadonilimab · Kaitanni
ApprovedMonoclonal antibody (anti-PD-1)
Cemiplimab · Libtayo
ApprovedCytotoxic chemotherapy (platinum)
Cisplatin · Platinol (generic)
ApprovedTIL cell therapy
Lifileucel · Amtagvi
ApprovedProphylactic vaccine (virus-like particles)
Nonavalent HPV vaccine · Gardasil 9
ApprovedMonoclonal antibody (anti-PD-1)
Pembrolizumab · Keytruda / Keytruda Qlex (SC)
Under reviewADC
Sacituzumab tirumotecan
ApprovedADC
Tisotumab vedotin · Tivdak
ApprovedCytotoxic (topoisomerase-I inhibitor)
Topotecan · Hycamtin
ApprovedADC
Trastuzumab deruxtecan · Enhertu

companies

10
AkesoAstraZenecaDaiichi SankyoGenmabIovance BiotherapeuticsMerck & Co. (MSD)Pfizer (incl. Seagen)RegeneronRoche / GenentechSichuan Kelun-Biotech

institutions

58
Advanced Centre for Treatment, Research and Education in CancerAll India Institute of Medical Sciences, New DelhiARCAGY-GINECOBC CancerButaro Cancer Center of ExcellenceCancer Council AustraliaCancer Institute (WIA), AdyarCancer Research UKCentre Oscar LambretCharlotte Maxeke Johannesburg Academic Hospital / University of the WitwatersrandChulabhorn Hospital / Chulabhorn Royal AcademyDharmais National Cancer CenterEuropean Society of Gynaecological OncologyGates FoundationGerman Cancer Research Center (DKFZ)GOG FoundationGroote Schuur Hospital / University of Cape TownHacettepe University Cancer InstituteHealthCare Global EnterprisesHo Chi Minh City Oncology HospitalHospital de Amor (Barretos Cancer Hospital)Hunan Cancer HospitalInstitut National d'Oncologie, RabatInstitut PasteurInstitut Salah AzaïezInstituto Nacional de Câncer (INCA)Instituto Nacional de Cancerología (Colombia)Instituto Nacional de Cancerología (Mexico)Instituto Nacional de Enfermedades NeoplásicasInternational Agency for Research on Cancer (IARC / WHO)IUCT Oncopole – Institut Universitaire du Cancer de ToulouseKaiser Permanente Division of ResearchKenyatta National HospitalKidwai Memorial Institute of OncologyKorle Bu Teaching HospitalLagos University Teaching HospitalLeiden University Medical CenterMarkey Cancer Center, University of KentuckyMD Anderson Cancer CenterNCI Center for Cancer Research (intramural programme)NRG OncologyOcean Road Cancer InstitutePeking Union Medical College HospitalPhilippine General HospitalPoliclinico Universitario A. GemelliPostgraduate Institute of Medical Education and Research, ChandigarhRajiv Gandhi Cancer Institute and Research CentreRutgers Cancer Institute of New JerseySociety of Gynecologic OncologyStephenson Cancer Center, OU HealthTata Memorial CentreTongji Hospital, Huazhong University of Science and TechnologyUganda Cancer InstituteUniversity of New Mexico Comprehensive Cancer CenterUZ Leuven / Leuven Cancer InstituteVietnam National Cancer Hospital (K Hospital)World Health Organization – Cancer ProgrammeZhejiang Cancer Hospital

pathways

1
Field cancerisation

terms

5
Cancer during pregnancyCervical precancer (CIN, HSIL/LSIL)Combined positive score (CPS)Squamous cell carcinomaTumour-agnostic (tissue-agnostic) approval

trials

12
BEATcc / ENGOT-Cx10 / GOG-3030COMPASSION-16 / AK104-303DESTINY-PanTumor02EMPOWER-Cervical 1 / GOG-3016 / ENGOT-cx9innovaTV 301 / ENGOT-cx12 / GOG-3057INTERLACEKEN SHE (single-dose HPV vaccine)KEYNOTE-826KEYNOTE-A18 / ENGOT-cx11 / GOG-3047LACC (Laparoscopic Approach to Cervical Cancer)OUTBACK / ANZGOG 0902 / GOG-0274SENTICOL III

pairings

4
Caution: minimally invasive radical hysterectomy for early cervical cancerInduction chemotherapy → chemoradiation (locally advanced cervical cancer)PD-1 blockade + chemoradiation (locally advanced cervical cancer)Radiotherapy + immunotherapy

roadmaps

1
Early detection roadmap: organ screening → blood tests for many cancers

ideas

30
A delivery-science moonshot for prevention we already ownA Global Fund for cancer care in low- and middle-income countriesA platform trial of very-low-cost metronomic chemotherapy in LMIC common cancersA ten-dollar blood test for the five cancers that kill most people in poorer countriesA therapeutic vaccine to clear cervical precancer without surgeryAI-first reading for high-volume common cancer diagnoses, pathologist for the exceptionsBlended finance and a low-cost linac to close the global radiotherapy gapBlock the complement signal that recruits tumour-protecting cellsBurden-matched funding for trials led in low- and middle-income countriesCommunity health workers trained in cancer triage, navigation and home palliative careCommunity-tailored HPV vaccine confidence campaigns with school-based deliveryConfirm ultra-low-dose immunotherapy so it can be afforded where most patients liveEliminate infection-caused cancers: HPV, hepatitis B and C, H. pylori and EBVHPV circulating tumour DNA to guide cervical cancer therapyHPV self-testing with same-day treatment as the national cervical programmeLow-cost cobalt-60 brachytherapy for cervical cancer in every regional centreMandatory staged registries for new surgical techniques before wide adoptionMobile diagnostic units that biopsy, scan and treat on the same visitModernised cobalt-60 machines as a deliberate bridge where linacs cannot be kept runningNurse-led chemotherapy day units with a doctor on a screenOffer HPV vaccination to women when they come for cervical screening or treatmentPost every woman an HPV self-test kit instead of asking her to book a smearRadiotherapy for everyone who needs it by 2040Same-day HPV test and heat treatment of precancer by nurses in low-income settingsSexual health assessed and treated as a standard toxicity domainSingle-dose HPV vaccination plus HPV self-sampling to reach WHO elimination in low-income countriesSocial impact bonds for cancer prevention, repaid from avoided treatment costsStop over-excluding people who could become pregnant; study pregnancy exposureSwitch every country to single-dose HPV vaccination and add catch-up to age 26Validate low-cost metronomic oral regimens in phase 3 and carry them into guidelines

people

11
André IlbawiDenise A. GallowayDouglas R. LowyGiovanni ScambiaHarald zur HausenHenrietta LacksIan FrazerJade GoodyJian ZhouPartha BasuSurendra Shastri

bottlenecks

5
Misinformation and unproven therapiesMost of the world has almost no cancer carePain relief and palliative care are unavailable to mostPrevention we already have is not deployedSurgery and radiotherapy cure most, get least

key papers

4
England's HPV programme: cervical cancer down 87% in the first cohort vaccinated at 12-13KEYNOTE-A18: pembrolizumab with chemoradiotherapy for locally advanced cervical cancerSelf-collected HPV samples are as accurate as clinician samples and reach women who never attend screeningSwedish registry study: HPV vaccination almost eliminates cervical cancer when given before 17

Key papers

4top
rctThe Lancet 2024changed practice
KEYNOTE-A18: pembrolizumab with chemoradiotherapy for locally advanced cervical cancer

Women with locally advanced cervical cancer that is node-positive or stage III-IVA should now be offered pembrolizumab alongside and after chemoradiotherapy, which improves the chance of cure. The result matters most in countries where cervical cancer is common but immunotherapy access is poorest, so its global impact depends on pricing and health-system capacity. It does not apply to early-stage disease treated with surgery or to lower-risk locally advanced disease without nodal involvement.

observationalThe Lancet 2021changed practice
England's HPV programme: cervical cancer down 87% in the first cohort vaccinated at 12-13

School-based vaccination at 12-13 with high uptake nearly abolishes cervical cancer in vaccinated cohorts, even with a vaccine covering only two HPV types. Screening intervals and the future of cervical screening can now be redesigned around vaccination status.

observationalNew England Journal of Medicine 2020changed practice
Swedish registry study: HPV vaccination almost eliminates cervical cancer when given before 17

Vaccinating girls before they are exposed to HPV prevents most cervical cancers. Catch-up vaccination in young adults still helps, but less. Combined with HPV screening, elimination of cervical cancer as a public health problem is a realistic goal.

meta analysisBMJ 2018changed practice
Self-collected HPV samples are as accurate as clinician samples and reach women who never attend screening

Women can collect their own screening sample at home with no loss of accuracy if the laboratory uses a PCR test. Sending kits directly is the most effective way to reach women who do not attend, which matters because most cervical cancers occur in under-screened women.

Latest papers

top
Literature trend3,859 papers in the last 12 months-4% vs prior 12How this is computed
Latest papers · live from Europe PMC
Open in Europe PMC

Query for this cancer: (TITLE:"Cervical cancer" OR ABSTRACT:"Cervical cancer") AND (treatment OR therapy OR trial OR survival OR diagnosis). Results are unfiltered search hits about Cervical cancer, not a curated reading list.

Connected

174top

technologies

18
Antibody-drug conjugate (ADC)BrachytherapyColposcopy and excisional treatment (LEEP/LLETZ, cone)Global oncology and access in low- and middle-income countriesHPV & HBV vaccinationHPV DNA testing and self-samplingHyperthermiaImmune checkpoint inhibitorsIMRT / IGRT (modern external beam)Liquid biopsy (ctDNA)MRD / molecular residual disease testingOncofertility and fertility preservationProton therapyRobotic & minimally invasive surgerySentinel lymph node biopsySmoking cessation in cancer patientsThermal ablation and cryotherapy for cervical precancerTIL therapy

targets

7
CTLA-4HER2PD-1PD-L1Tissue factorTROP2VEGF / VEGFR

drugs

12
ApprovedMonoclonal antibody (anti-PD-L1)
Atezolizumab · Tecentriq / Tecentriq Hybreza (SC)
ApprovedMonoclonal antibody (anti-VEGF)
Bevacizumab · Avastin (and biosimilars)
Not filedBispecific antibody (PD-1×CTLA-4)
Cadonilimab · Kaitanni
ApprovedMonoclonal antibody (anti-PD-1)
Cemiplimab · Libtayo
ApprovedCytotoxic chemotherapy (platinum)
Cisplatin · Platinol (generic)
ApprovedTIL cell therapy
Lifileucel · Amtagvi
ApprovedProphylactic vaccine (virus-like particles)
Nonavalent HPV vaccine · Gardasil 9
ApprovedMonoclonal antibody (anti-PD-1)
Pembrolizumab · Keytruda / Keytruda Qlex (SC)
Under reviewADC
Sacituzumab tirumotecan
ApprovedADC
Tisotumab vedotin · Tivdak
ApprovedCytotoxic (topoisomerase-I inhibitor)
Topotecan · Hycamtin
ApprovedADC
Trastuzumab deruxtecan · Enhertu

companies

6
AkesoGenmabMerck & Co. (MSD)Pfizer (incl. Seagen)RegeneronRoche / Genentech

institutions

58
Advanced Centre for Treatment, Research and Education in CancerAll India Institute of Medical Sciences, New DelhiARCAGY-GINECOBC CancerButaro Cancer Center of ExcellenceCancer Council AustraliaCancer Institute (WIA), AdyarCancer Research UKCentre Oscar LambretCharlotte Maxeke Johannesburg Academic Hospital / University of the WitwatersrandChulabhorn Hospital / Chulabhorn Royal AcademyDharmais National Cancer CenterEuropean Society of Gynaecological OncologyGates FoundationGerman Cancer Research Center (DKFZ)GOG FoundationGroote Schuur Hospital / University of Cape TownHacettepe University Cancer InstituteHealthCare Global EnterprisesHo Chi Minh City Oncology HospitalHospital de Amor (Barretos Cancer Hospital)Hunan Cancer HospitalInstitut National d'Oncologie, RabatInstitut PasteurInstitut Salah AzaïezInstituto Nacional de Câncer (INCA)Instituto Nacional de Cancerología (Colombia)Instituto Nacional de Cancerología (Mexico)Instituto Nacional de Enfermedades NeoplásicasInternational Agency for Research on Cancer (IARC / WHO)IUCT Oncopole – Institut Universitaire du Cancer de ToulouseKaiser Permanente Division of ResearchKenyatta National HospitalKidwai Memorial Institute of OncologyKorle Bu Teaching HospitalLagos University Teaching HospitalLeiden University Medical CenterMarkey Cancer Center, University of KentuckyMD Anderson Cancer CenterNCI Center for Cancer Research (intramural programme)NRG OncologyOcean Road Cancer InstitutePeking Union Medical College HospitalPhilippine General HospitalPoliclinico Universitario A. GemelliPostgraduate Institute of Medical Education and Research, ChandigarhRajiv Gandhi Cancer Institute and Research CentreRutgers Cancer Institute of New JerseySociety of Gynecologic OncologyStephenson Cancer Center, OU HealthTata Memorial CentreTongji Hospital, Huazhong University of Science and TechnologyUganda Cancer InstituteUniversity of New Mexico Comprehensive Cancer CenterUZ Leuven / Leuven Cancer InstituteVietnam National Cancer Hospital (K Hospital)World Health Organization – Cancer ProgrammeZhejiang Cancer Hospital

pathways

1
Field cancerisation

terms

5
Cancer during pregnancyCervical precancer (CIN, HSIL/LSIL)Combined positive score (CPS)Squamous cell carcinomaTumour-agnostic (tissue-agnostic) approval

trials

12
BEATcc / ENGOT-Cx10 / GOG-3030COMPASSION-16 / AK104-303DESTINY-PanTumor02EMPOWER-Cervical 1 / GOG-3016 / ENGOT-cx9innovaTV 301 / ENGOT-cx12 / GOG-3057INTERLACEKEN SHE (single-dose HPV vaccine)KEYNOTE-826KEYNOTE-A18 / ENGOT-cx11 / GOG-3047LACC (Laparoscopic Approach to Cervical Cancer)OUTBACK / ANZGOG 0902 / GOG-0274SENTICOL III

pairings

4
Caution: minimally invasive radical hysterectomy for early cervical cancerInduction chemotherapy → chemoradiation (locally advanced cervical cancer)PD-1 blockade + chemoradiation (locally advanced cervical cancer)Radiotherapy + immunotherapy

roadmaps

1
Early detection roadmap: organ screening → blood tests for many cancers

ideas

30
A delivery-science moonshot for prevention we already ownA Global Fund for cancer care in low- and middle-income countriesA platform trial of very-low-cost metronomic chemotherapy in LMIC common cancersA ten-dollar blood test for the five cancers that kill most people in poorer countriesA therapeutic vaccine to clear cervical precancer without surgeryAI-first reading for high-volume common cancer diagnoses, pathologist for the exceptionsBlended finance and a low-cost linac to close the global radiotherapy gapBlock the complement signal that recruits tumour-protecting cellsBurden-matched funding for trials led in low- and middle-income countriesCommunity health workers trained in cancer triage, navigation and home palliative careCommunity-tailored HPV vaccine confidence campaigns with school-based deliveryConfirm ultra-low-dose immunotherapy so it can be afforded where most patients liveEliminate infection-caused cancers: HPV, hepatitis B and C, H. pylori and EBVHPV circulating tumour DNA to guide cervical cancer therapyHPV self-testing with same-day treatment as the national cervical programmeLow-cost cobalt-60 brachytherapy for cervical cancer in every regional centreMandatory staged registries for new surgical techniques before wide adoptionMobile diagnostic units that biopsy, scan and treat on the same visitModernised cobalt-60 machines as a deliberate bridge where linacs cannot be kept runningNurse-led chemotherapy day units with a doctor on a screenOffer HPV vaccination to women when they come for cervical screening or treatmentPost every woman an HPV self-test kit instead of asking her to book a smearRadiotherapy for everyone who needs it by 2040Same-day HPV test and heat treatment of precancer by nurses in low-income settingsSexual health assessed and treated as a standard toxicity domainSingle-dose HPV vaccination plus HPV self-sampling to reach WHO elimination in low-income countriesSocial impact bonds for cancer prevention, repaid from avoided treatment costsStop over-excluding people who could become pregnant; study pregnancy exposureSwitch every country to single-dose HPV vaccination and add catch-up to age 26Validate low-cost metronomic oral regimens in phase 3 and carry them into guidelines

people

11
André IlbawiDenise A. GallowayDouglas R. LowyGiovanni ScambiaHarald zur HausenHenrietta LacksIan FrazerJade GoodyJian ZhouPartha BasuSurendra Shastri

bottlenecks

5
Misinformation and unproven therapiesMost of the world has almost no cancer carePain relief and palliative care are unavailable to mostPrevention we already have is not deployedSurgery and radiotherapy cure most, get least

key papers

4
England's HPV programme: cervical cancer down 87% in the first cohort vaccinated at 12-13KEYNOTE-A18: pembrolizumab with chemoradiotherapy for locally advanced cervical cancerSelf-collected HPV samples are as accurate as clinician samples and reach women who never attend screeningSwedish registry study: HPV vaccination almost eliminates cervical cancer when given before 17