S16 Ep12: Evolving Standards and Emerging ADCs Redefine Cervical Cancer Care: With Ursula A. Matulonis, MD; and Susana M. Campos, MD, MPH

From Discovery to Delivery: Charting Progress in Gynecologic Oncology, hosted by Ursula A. Matulonis, MD, brings expert insights into the most recent breakthroughs, evolving standards, and emerging therapies across gynecologic cancers. Dr Matulonis is chief of the Division of Gynecologic Oncology and the Brock-Wilcon Family Chair at the Dana-Farber Cancer Institute, as well as a professor of medicine at Harvard Medical School, both in Boston, Massachusetts.

In this episode, Dr Matulonis sat down with guest Susana M. Campos, MD, MPH. Dr Campos is the clinical director and director of Educational Initiatives for the of the Division of Gynecologic Oncology at Dana-Farber Cancer Institute, and an institute physician and assistant professor of medicine at Harvard Medical School in Boston, Massachusetts. 

Drs Matulonis and Campos discussed the evolving landscape of newly diagnosed cervical cancer, from epidemiologic trends to emerging therapeutic strategies.

According to 2026 estimates from the American Cancer Society, approximately 13,400 new cases of invasive cervical cancer will be diagnosed in the United States, with roughly 4200 deaths. Although incidence has declined over time due to human papillomavirus (HPV) vaccination and screening efforts, rates have plateaued, and the disease burden remains substantial, particularly among women aged 35 to 64 years. Dr Campos noted that approximately half of cases occur in women younger than 50 years of age, and about 20% are diagnosed in women older than 65 years of age.

Dr Campos reviewed common presenting symptoms, including abnormal vaginal bleeding, intermenstrual or postmenopausal bleeding, abnormal discharge, pelvic pain, and, in advanced cases, urinary symptoms or leg swelling. She explained that diagnosis begins with pelvic examination and cervical cytology or HPV testing, followed by colposcopy and biopsy when indicated. Although cervical cancer remains one of the few malignancies that is clinically staged, imaging modalities, such as MRI, CT, and PET scans, are critical to accurately defining disease extent, they underscored. 

Moreover, the discussion highlighted transformative advances in locally advanced disease. The phase 3 KEYNOTE-A18 trial (NCT04221945) demonstrated improved progression-free and overall survival with the addition of pembrolizumab (Keytruda) to standard chemoradiation, establishing a new standard for high-risk patients, Campos stated. Similarly, the phase 3 INTERLACE trial (NCT01566240) showed that short-course induction chemotherapy with carboplatin and paclitaxel before chemoradiation improved long-term outcomes. Campos forecasted that ongoing studies, including the phase 3 NRG-GY037 trial (NCT07061977), may integrate these approaches and further refine optimal treatment sequencing.

Lastly, Drs Matulonis and Campos highlighted the expanding therapeutic arsenal in the recurrent and metastatic setting. Campos noted how antibody-drug conjugates, such as tisotumab vedotin-tftv (Tivdak) and fam-trastuzumab deruxtecan-nxki (Enhertu), have demonstrated meaningful activity, particularly in biomarker-selected populations. Campos added that investigational strategies targeting TROP2, such as sacituzumab govitecan-hziy (Trodelvy), represent additional promising avenues.

Despite these advances, both experts emphasized that prevention remains paramount. Widespread uptake of HPV vaccination, including the 9-valent vaccine, as well as adherence to routine cervical screening, are essential to reducing the long-term burden of this largely preventable disease.