Induction Pembrolizumab and Chemotherapy Followed by Pembrolizumab Before Chemoradiation and Pembrolizumab Maintenance Compared to Standard Chemoradiation With Pembrolizumab Followed by Pembrolizumab Maintenance in High-Risk Cervical Cancer
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What is cervical cancer?
Cervical cancer starts in the cervix, the lower part of the uterus that opens into the vagina. Almost all cases, more than 90 percent, are caused by persistent infection with high risk types of human papillomavirus, especially types 16 and 18. Most people clear HPV on their own; in a minority the infection persists and, over 10 to 20 years, turns cells precancerous and then cancerous. That slow timeline is why screening works: Pap tests find abnormal cells, HPV tests find the virus, and precancers can be removed before cancer develops. Early cervical cancer causes no symptoms. Later it can cause bleeding between periods or after sex, unusual discharge, and pelvic pain. It is most often diagnosed between 35 and 64, and smoking, a weakened immune system, and long term birth control pill use raise the risk in women with HPV.
Screening and prevention are changing quickly. Since 2024 the FDA has approved HPV tests on self collected samples, first in clinics and since 2025 at home, and both the American Cancer Society and federal guidelines now include self collection as an option. Treatment depends on stage: surgery for early cancers, sometimes preserving fertility; chemotherapy with radiation for locally advanced disease, with the immunotherapy pembrolizumab added since 2024 for higher risk cases after a trial showed it improved survival; and for recurrent or metastatic disease, immunotherapy, the antibody drug conjugate tisotumab vedotin, and chemotherapy. When caught early, five year survival is above 90 percent; once it has spread widely, it falls below 20 percent. Trials now test giving immunotherapy before chemoradiation, new antibody drug conjugates, and blood tests that detect HPV DNA to track the cancer. Our guide explains how clinical trials for cancer work.
Types of cervical cancer clinical trials
Locally advanced disease trials. Immunotherapy given before, during, or after chemoradiation, including a 335 site Phase 3 trial run by the National Cancer Institute and a Phase 3 trial of a new bispecific antibody.
Recurrent and metastatic trials. Antibody drug conjugates, immunotherapy combinations, and targeted drugs for cancer that has returned or spread, several in Phase 3.
Early stage and fertility trials. Less extensive surgery and chemotherapy before surgery in young women who want to preserve fertility.
Monitoring studies. Blood tests for HPV DNA that may detect recurrence earlier than scans.
Screening and outreach studies. Self collection, point of care tests, and programs that reach women who have never been screened; detailed on our HPV page.
Supportive care. Managing side effects of radiation and chemotherapy, including eye side effects of newer drugs.
Is cervical cancer curable?
Often, when found early: five year survival for cancer confined to the cervix is above 90 percent. Locally advanced cancer is treated with chemoradiation, now with immunotherapy for higher risk cases, and many women are cured. Widely spread cancer is treated to extend life, and that is where most new drug trials focus.
Who can participate in cervical cancer clinical trials?
Treatment trials enroll women with a confirmed diagnosis at a specific stage: newly diagnosed locally advanced disease before chemoradiation begins, or recurrent and metastatic disease after a defined number of prior treatments. Many require tumor testing for PD-L1 or other markers, adequate organ function, and the ability to manage daily activities. Some Phase 3 trials accept patients from age 15. Fertility sparing trials enroll young women with early stage tumors. Monitoring and screening studies have wider doors, enrolling women during or after treatment or those due for screening. Eligibility always varies by study; our guide covers eligibility criteria.
The stages of cervical cancer, and why they matter for trials
Stage I. Confined to the cervix. Surgery, sometimes fertility sparing; five year survival above 90 percent. Trials test less extensive surgery.
Stage II and III. Spread to nearby tissue, the lower vagina, or the pelvic wall and lymph nodes. Chemoradiation, with immunotherapy added since 2024 for higher risk cases. The largest group of trials recruits here.
Stage IV. Spread to the bladder, rectum, or distant organs. Systemic therapy; most antibody drug conjugate and immunotherapy trials recruit here and in recurrent disease.
Study titles say "locally advanced," "recurrent," or "metastatic," and often "PD-L1 positive." Your stage and any biomarker results tell you which studies fit.
How to enroll in a cervical cancer clinical trial
Identify your trial. Use the filters. Titles name the stage and whether the study is for newly diagnosed or recurrent disease.
Select your preferred location. Enter your city or state. The large Phase 3 trials run at hundreds of sites; early phase studies at gynecologic oncology centers.
Explore study details. Click "Learn More" for stage and biomarker requirements, prior treatments, and the visit schedule.
Complete the health profile. Click "Get started" to begin the 5-step application. Have three things ready: your stage, your biomarker results if tested, and the treatments you have had.
Submit the application. A clinical trial coordinator reviews it and contacts you. Nothing is decided until informed consent, and participation is voluntary at every step.