Introduction/Background Historically, first-line metastatic cervical carcinoma treatment relied on platinum-paclitaxel chemotherapy with or without Bevacizumab, yielding poor prognosis. This study aims to conduct a real-world analysis of the PDL1 effect assessment and the incorporation of immunotherapy (IT) into the standard regimen over the past two years.

Methodology A retrospective observational cohort study involving 56 patients with stage IV cervical carcinoma treated between 2010 and 2023. The cohort consists of 30 new patients with PDL1 determination and 26 old patients lacking PDL1 evaluation. The primary variable is Progression-Free Survival (PFS) in new cases concerning immunotherapy and PFS in old cases. Secondary variables include age at diagnosis, histology, grade (G), radiotherapy, bevacizumab, overall survival in old cases, and response rates.

Results Both groups exhibited no significant differences in mean age at diagnosis (53 years), squamous cell carcinoma histology (82.1%), G3 (62.5%), and radiotherapy rates (75–80%).

A significant difference was observed in the Bevacizumab administration (p=0.023), with 28% of old cases receiving it compared to 59% of new cases. However, PFS was more favorable in old cases with bevacizumab, while new cases did not exhibit the same benefit. Median OS in old cases was 8 months.

Among the new cases, 83.3% tested positive for PDL1. Statistically significant differences were noted (p<0,001; U Mann-Whitney Test) in median PFS, with the IT patient group demonstrating superior outcomes than without IT group: 12 [6–22,5] months versus 3 [2–12] months, respectively.

IT resulted in a higher response rate (92%) in contrast to cases without IT (31.6%). Response types with IT included 42.9% complete response (CR), 50% partial response (PR) and 7.1% progression (P). In cases without IT, the responses included CR (15.8%), PR (15.8%), stable disease (SD, 28.9%), 39.5% P (p=0.001).

Conclusion Results demonstrate a PFS increase in patients receiving immunotherapy regardless Bevacizumab addition, being consistent with the phase 3 KEYNOTE-826 results.

Disclosures No.