OBJECTIVES: Treatment landscape for advanced cervical cancer (aCC) is evolving with immunotherapy in addition to chemotherapy demonstrating overall survival benefit in the KEYNOTE-826. This study aims to provide a baseline view of real-world aCC care patterns in England, 2012-2019, to inform future potential benefit as more therapies become available for this patient population.

METHODS: Adult female patients were identified in National Cancer Registration and Analysis Service (NCRAS) and included in the study if they had a diagnosis of cervical cancer between 2012-2018, and ≥1 administration of systemic chemotherapy (beyond surgery) between 2012-2019. Patients were required to have ≥1 year of follow-up data since initiating chemotherapy, or a date of death. Clinical trial patients were excluded. The data used for this study were extracted from the NCRAS datasets linked with the Hospital Episode Statistics inpatient and outpatient datasets.

RESULTS: A total of N=4,002 patients were included. Mean age at initiation of chemotherapy was 48.7 years, 58.5% had a history of radiotherapy, and comorbidities such as hypertension, gastrointestinal diseases, as well as other chronic pulmonary diseases were common (>10% respectively). Mean follow-up time of this cohort was 2.8 years, during which period 42.0% of patients died. Majority of patients (59.6%) initiated treatment with platinum-based monotherapy+radiotherapy. Chemotherapy doublets (platinum+taxane) or triplets (with bevacizumab) were the next most prescribed regimen, accounting for approximately one-fifth of total treatment. N=1,112 had evidence of subsequent therapy, among whom platinum-based monotherapy+radiotherapy and chemotherapy doublet±bevacizumab were most commonly used (35-40% respectively). Among patients initiating a subsequent therapy, we observed that 61.2% had died over 2.5 years mean follow-up time.

CONCLUSIONS: Women with aCC in England face a disease with high morbidity and mortality rates. Findings warrant further research to understand drivers of poor clinical outcome and inform how emerging therapies may begin to address the unmet need in this patient population.