Are there patient populations in whom you would consider using both induction chemotherapy and maintenance pembrolizumab for a patient with locally advanced cervical cancer?

Would consider for patients with multiple pelvic and high pa bulky nodes where risk of distant mets is extremely high, with the goal to treat with systemic intent, and if good response and no mets, proceed to definitive chemo-RT.

This has been discussed but there is no current data on the combination of INTERLACE followed by A18. There are certain clinical situations (large tumor, node-positive) that I may consider it. But this would be on a case-to-case basis.

In light of this discussion, I would recommend consideration of opening NRG GY037 at your institution. This trial will randomize between induction chemo/IO → chemoRT → adjuvant IO vs chemoRT → adjuvant IO alone.