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Locally advanced cervical cancer: lines of therapy

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

LineAll comersRisk group
Screening, prevention and diagnosis1·
Early / localised·1
Advanced, first line1·
Second line1·
Other settings2·

Screening, prevention and diagnosis

SubgroupSettingApproachProducts and trialsEvidence
All comersStagingPelvic MRI and whole-body PET-CT; surgical para-aortic staging in selected cases.92

Early / localised

SubgroupSettingApproachProducts and trialsEvidence
Risk groupHigh-risk disease (node-positive IB2 to IIB, III to IVA)Pembrolizumab with chemoradiation and for up to two years afterwards (KEYNOTE-A18).98

Advanced, first line

SubgroupSettingApproachProducts and trialsEvidence
All comersInduction optionSix weekly cycles of carboplatin-paclitaxel before chemoradiation (INTERLACE), particularly where immunotherapy is not available.87

Second line

SubgroupSettingApproachProducts and trialsEvidence
All comersCentral pelvic recurrence after radiotherapyPelvic exenteration in selected patients; re-irradiation with brachytherapy or protons in specialist centres.40

Other settings

SubgroupSettingApproachProducts and trialsEvidence
All comersStandard chemoradiationWeekly cisplatin with pelvic external-beam radiotherapy followed by image-guided brachytherapy, completed within eight weeks.93
All comersNot recommendedAdjuvant carboplatin-paclitaxel after chemoradiation gave no benefit in OUTBACK.82

Sequence and caution pairings

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.