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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.

LineAll comersHER2
Advanced, first line1·
Second line2·
Third line and beyond1·
Other settings·1

Advanced, first line

SubgroupSettingApproachProducts and trialsEvidence
All comersFirst linePembrolizumab 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.98

Second line

SubgroupSettingApproachProducts and trialsEvidence
All comersSecond line after platinumTisotumab vedotin (innovaTV 301) with prophylactic eye care; cemiplimab (EMPOWER-Cervical 1) if no prior immunotherapy.98
All comersIsolated pelvic recurrence after radiotherapyPelvic exenteration in fit patients without sidewall fixation.93

Third line and beyond

SubgroupSettingApproachProducts and trialsEvidence
All comersLater linesSingle-agent chemotherapy (topotecan, gemcitabine, pemetrexed, vinorelbine) with modest response; clinical trials of new antibody-drug conjugates and cell therapy preferred.90

Other settings

SubgroupSettingApproachProducts and trialsEvidence
HER2HER2-expressing diseaseTrastuzumab deruxtecan after prior therapy (DESTINY-PanTumor02).97

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.