This protocol addresses the management of cervical cancer that has recurred or spread to distant sites in patients who are medically fit and have not previously received chemotherapy.
The patient presents with recurrent or metastatic cervical cancer. They are chemotherapy-naive — no prior systemic chemotherapy has been administered — and are considered medically fit, making them candidates for combination systemic therapy.
The recommended approach involves platinum-based combination chemotherapy as the backbone of treatment. Depending on individual patient factors — including tumour biology and a careful assessment of toxicity risk — additional agents may be incorporated alongside the platinum-based regimen. The complete regimen selection, sequencing, and criteria for adding further agents are detailed in the full protocol.
Platinum-based chemotherapy ± bevacizumab is recommended for chemo-naïve, medically fit patients with recurrent/metastatic disease.
Carboplatin/paclitaxel and cisplatin/paclitaxel are the preferred regimens.
The addition of bevacizumab to platinum-based chemotherapy is recommended when the risk of significant gastrointestinal/genitourinary toxicities has been carefully assessed and discussed with the patient.
The addition of pembrolizumab to platinum-based chemotherapy ± bevacizumab is recommended in patients with PD-L1 positive tumors, assessed as a combined positive score of 1 or more.
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