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Cervical Cancer — SCE Medical Oncology MCQ

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HardGynaecological CancersCervical CancerSCE Medical Oncology

A patient with PD-L1 CPS 6 metastatic cervical cancer is starting pembrolizumab with carboplatin-paclitaxel. A recent rectovaginal fistula makes bevacizumab unsuitable. Which interpretation of NICE TA939 is correct?

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Correct answer: AProceed with pembrolizumab and platinum-paclitaxel because bevacizumab is optional in the appraised regimen

TA939 recommends pembrolizumab plus platinum-based chemotherapy and paclitaxel with or without bevacizumab for CPS at least 1 disease. A fistula makes bevacizumab unattractive, but does not remove the pembrolizumab-chemotherapy option because bevacizumab is explicitly optional. Pembrolizumab monotherapy, cetuximab substitution and default topotecan are not the appraised first-line regimen.

Reference: NICE TA939 pembrolizumab plus chemotherapy with or without bevacizumab for cervical cancer (Published December 2023): https://www.nice.org.uk/guidance/ta939/chapter/1-Recommendations