Jyoti S. Mayadev, MD, on Atezolizumab for Locally Advanced, Node-Positive Cervical Cancer


At SGO 2022, Jyoti S. Mayadev, MD presented results of the NRG-GY017 trial of atezolizumab as either an immune primer or with chemoradiation for certain patients with locally advanced cervical cancer.

CancerNetwork® sat down with Jyoti S. Mayadev, MD, associate professor of Radiation Medicine and Applied Sciences and assistant vice chair in Developmental Therapeutics and Section Chief of Gynecologic Oncology at UC San Diego School of Medicine, at The Society of Gynecologic Oncology (SGO) 2022 Annual Meeting on Women’s Cancer to discuss the phase 1 NRG-GY017 trial (NCT03738228) trial that showed promised of atezolizumab (Tecentriq) in the setting of locally advanced cervical cancer.

Atezolizumab, a PD-L1 inhibitor used either before as an immune primer and/or with chemoradiotherapy, led to promising outcomes in terms of progression-free survival and safety for patients with node-positive disease in stages IB2, II, IIIB, or IVA.


We chose a population with high-risk, node-positive [disease], including periodic node-positive cervical cancer because these patients represent an unmet need. They have recurrence rates of up to 60% after standard chemoradiation, and we know that cervical cancer is an immunogenic disease. Therefore, we try to use immune primers to stimulate the immune system using anti–PD-L1 immune checkpoint blockade before and during chemoradiation. We also tried to look at the difference in immunogenicity between the 2 arms of the trial—the priming arm vs the concurrent [therapy] arm—to determine if that would be a signal for response and overall survival.

The key highlights are that it is safe to combine an immune checkpoint blockade like atezolizumab, or an anti–PD-L1 agent, with chemoradiation and we observed very low DLTs [dose-limiting toxicities] in patients who responded to chemoradiation. There was no delay in chemoradiation, so you could give the full dose of standard chemoradiation. The second finding was that we looked at the T-cell clones in the patient’s peripheral blood and tumors and we found that patients who received chemoradiation had an expansion of T-cell clonality. They were new novel clones as opposed to just tumor-associated clones.


Mayadev J, Zamarin D, Deng W, et al. Safety and immunogenicity of anti PD-L1 (Atezolizumab) given as an immune primer or concurrently with extended field chemoradiotherapy for node positive locally advanced cervical cancer: an NRG Oncology trial. Presented at: 2022 SGO Annual Meeting on Women’s Cancer; March 18-21, 2022; Phoenix, Arizona.

Related Videos
Although immature, overall survival data from the KEYNOTE-868 trial may support the use of pembrolizumab plus chemotherapy in patients with endometrial cancer.
Dostarlimab plus chemotherapy appears to yield favorable overall survival in patients with mismatch repair proficient endometrial cancer.
Brian Slomovitz, MD, MS, FACOG discusses the use of new antibody drug conjugates for treating patients with various gynecologic cancers.
Developing novel regimens may continue to improve survival outcomes of patients with advanced cervical cancer following the FDA approval of pembrolizumab and chemoradiation, says Jyoti S. Mayadev, MD.
Treatment with pembrolizumab plus chemoradiation appears to be well tolerated with no detriment to quality of life among those with advanced cervical cancer.
Jyoti S. Mayadev, MD, says that pembrolizumab in combination with chemoradiation will be seamlessly incorporated into her institution’s treatment of those with FIGO 2014 stage III to IVA cervical cancer following the regimen’s FDA approval.
Despite the addition of a TIGIT inhibitor to a checkpoint inhibitor resulting in high levels of safety, there is no future for that combination alone, according to Ritu Salani, MD.
Treatment with tisotumab vedotin may be a standard of care in second- or third-line recurrent or metastatic cervical cancer, says Brian Slomovitz, MD, MS, FACOG.
Related Content