Pembrolizumab Registry for Outcomes and Treatment Evaluation in Cervical Cancer (PROTECx)

June 11, 2026 updated by: University Medical Center Groningen
This is a nationwide, multicenter, registry-based prospective cohort study to assess real-world effectiveness of treatment with a pembrolizumab containing regimen in persistent, recurrent, or metastatic cervical cancer. Patients in the observation cohort continue treatment according to standard of care. In the discontinuation cohort, patients discontinue their maintenance treatment with pembrolizumab (with or without discontinuation of bevacizumab). Patients may choose to discontinue pembrolizumab prematurely (with or without discontinuation of bevacizumab) if they achieve a confirmed CR or a confirmed PR to treatment, or on patient's request or due to toxicity. If an eligible patient chooses not to discontinue treatment early they will remain in the observation cohort. The duration of the trial for the individual patient will be until two years from the start of treatment. Survival follow-up will continue for a maximum of 10 years

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

261

Phase

  • Phase 4

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

  • Netherlands
      • Amsterdam, Netherlands
      • Amsterdam, Netherlands
        • Not yet recruiting
        • Antoni van Leeuwenhoek Ziekenhuis
        • Contact:
        • Principal Investigator:
          • M. A. Rijlaarsdam
      • Eindhoven, Netherlands
      • Enschede, Netherlands
        • Not yet recruiting
        • Medisch Spectrum Twente
        • Contact:
        • Principal Investigator:
          • A. N.M. Wymenga
      • Groningen, Netherlands, 9713 GZ
        • Recruiting
        • University Mecdical Center Groningen
        • Contact:
        • Contact:
        • Principal Investigator:
          • M. Jalving, MD, PhD
      • Leiden, Netherlands
        • Not yet recruiting
        • LUMC
        • Contact:
        • Principal Investigator:
          • J. R. Kroep
      • Maastricht, Netherlands
        • Not yet recruiting
        • Maastricht UMC
        • Contact:
        • Principal Investigator:
          • A. J.M. Beijers
      • Nijmegen, Netherlands
      • Rotterdam, Netherlands
        • Not yet recruiting
        • Erasmus MC
        • Contact:
        • Principal Investigator:
          • I. A. Boere
      • Utrecht, Netherlands
      • Zwolle, Netherlands
        • Not yet recruiting
        • Isala Klinieken
        • Contact:
        • Principal Investigator:
          • W. A. van der Steeg

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion criteria for the observation cohort:

• Persistent, recurrent, or metastatic cervical cancer commencing treatment or currently treated with a pembrolizumab containing regimen.

Inclusion criteria for the early discontinuation cohort:

  • Previous inclusion in the observation cohort

  • Choice made to stop pembrolizumab for one of the following reasons:

    • Confirmed complete response if they had received at least 8 cycles of 3- weekly pembrolizumab, including at least 9 weeks beyond a CR (consistent with KEYNOTE-826 criteria) OR
    • Immune-related toxicity grade ≥ 3 OR
    • Patient's preference (e.g. chronic or invalidating grade 1-2 immune-related toxicity) OR
    • Confirmed partial response if they had received at least 8 cycles of 3- weekly pembrolizumab, including at least 9 weeks beyond a PR (timing consistent with KEYNOTE-826 criteria)
  • Eligible and willing to discontinue pembrolizumab (with or without discontinuing bevacizumab)

Exclusion criteria for all cohorts are:

  • Malignant other disease other than cervical carcinoma that required active treatment in the past 2 years: Participants with basal cell carcinoma of the skin, squamous cell carcinoma of the skin, transitional cell carcinoma of urothelial cancer, or any carcinoma in situ that have undergone potentially curative therapy are not excluded
  • Any psychological, familial, sociological or geographical condition or a known psychiatric or substance abuse disorder potentially hampering compliance with the study protocol and follow-up schedule; those conditions should be discussed with the patient before registration in the trial. This comprises each and every condition or circumstance preventing the patient from showing up to the outpatient controls and/or undergoing the CT-scans, or preventing the patient from (adequately) filling out the questionnaires.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Non-Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
No Intervention: Observation cohort
The observation cohort will consist of all participants who receive standard of care treatment and are not eligible for the discontinuation cohort or do not wish to discontinue treatment. Patients will be asked to complete questionnaires every 12 weeks.
Experimental: Discontinuation cohort
The discontinuation cohort will consist of participants who discontinue pembrolizumab (with or without discontinuation of bevacizumab) therapy early according to the inclusion criteria listed in the study protocol. Additionally, will be asked to complete questionnaires every 12 weeks.
Drug: Early discontinuation of Pembrolizumab with or without Bevacizumab
  1. Keytruda, (L01XC18), pembrolizumab, intravenous administration (administered as standard of care).
  2. Avastin, (L01FG01), bevacizumab, intravenous administration (administered as standard of care).

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Evaluate the progression-free survival (PFS) and compare to the KEYNOTE-826 trial
Time Frame: 12 months; for all patients

To evaluate the progression PFS at 12 months and compare it to the historical PFS at 12 months of the KEYNOTE-826 trial.

PFS is defined as the time from start of first line treatment to the first documented disease progression or death due to any cause, whichever occurs first.
12 months; for all patients

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Evaluate progression-free survival (PFS) at 12- and 24 months
Time Frame: 12 and 24 months; for all patients

To evaluate the PFS at 12- and 24 months for the complete cohort; the observation cohort and the discontinuation cohort separately and per the different response outcomes (SD/PR/CR).

PFS is defined as the time from start of first line treatment to the first documented disease progression or death due to any cause, whichever occurs first.
12 and 24 months; for all patients
To evaluate Overall Survival (OS)
Time Frame: From enrollment till the end of survival follow-up of ten years or death. Median OS is estimated to be available at the half of total inclusion period (1,5 of 3 years) + median OS from registration trial, so expected at 56 months from trial start

To evaluate the OS, OS is defined as: the time from start of first line treatment to death due to any cause.

Survival curves will be plotted, the OS rate at different time points will be estimated using the Kaplan-Meier method and the median OS wil be evaluated.

Survival follow-up is for up to ten years after commencement of treatment. To give an indication: median OS in the KEYNOTE-826 trial for CPS≥1 (trial population) cohort was 28.6 months and 24-months OS 53.5%.
From enrollment till the end of survival follow-up of ten years or death. Median OS is estimated to be available at the half of total inclusion period (1,5 of 3 years) + median OS from registration trial, so expected at 56 months from trial start
Evaluate objective response rate (ORR)
Time Frame: The ORR will be evaluated if all patients have had all response evaluations, this will be estimated at around 5 years (3 year inclusion + 2 year follow-up) after start of study.

To evaluate the ORR, ORR is defined as the proportion of patients with CR and PR.

Response for the individual patient will be measured/assessed every 12-18 (±1) weeks starting from baseline till two years of treatment, progression or death.
The ORR will be evaluated if all patients have had all response evaluations, this will be estimated at around 5 years (3 year inclusion + 2 year follow-up) after start of study.
Evaluate duration of response (DoR)
Time Frame: from enrollement till disease progression, follow-up or death assesed up to about 48 months since commencement of treatment.
To evaluate the DoR, which is defined as the time from the first documented evidence of CR or PR until the first documented disease progression or death due to any cause, whichever occurs assesed up to about 48 months since commencement of treatment.
from enrollement till disease progression, follow-up or death assesed up to about 48 months since commencement of treatment.
To describe the percentage of patients that develop immune-related endocrinopathies
Time Frame: from commencement of treatment to the end of regular follow-up (+/- 48 months) or disease progression.

The percentage of patients that develop immune-related endocrinopathies

Ir(S)AEs are collected until end of standard follow-up (2 years or disease progression).
from commencement of treatment to the end of regular follow-up (+/- 48 months) or disease progression.
To evaluate the treatment related Immune-Related (Serious) Adverse Events (ir(S)AEs) which led to discontinuation or interruption of systemic treatment.
Time Frame: from commencement of treatment to the end of regular follow-up (+/- 48 months) or disease progression.

To describe the percentage of patients which irAEs led to discontinuation or interruption (≥12 weeks) of treatment during (rechallenge of) PD-1 blockade.

Ir(S)AEs are collected until end of standard follow-up (2 years or disease progression).
from commencement of treatment to the end of regular follow-up (+/- 48 months) or disease progression.
The Health-Related Quality of Life in patients with recurrent, persistent or metastatic cervical cancer treated with a pembrolizumab-containing regimen
Time Frame: from enrollment till the end of treatment (two years from commencing treatment), every three months both questionnaires will be sent.
The European Organisation For Research And Treatment Of Cancer (EORTC) QLQ-C30. The tool is composed of both multi-item scales and single-item measures. These include five functional scales, three symptom scales, a global health status/QoL scale, and six single items. All of the scales and single-item measures range in score from 0 to 100. A high score for a functional scale represents a high/healthy level of functioning, a high score for the global health status/QoL represents a high QoL, a high score for a symptom scale/item represents a high level of symptomatology/problems
from enrollment till the end of treatment (two years from commencing treatment), every three months both questionnaires will be sent.
The anxiety and depression symptoms in patients with recurrent, persistent or metastatic cervical cancer treated with a pembrolizumab-containing regimen
Time Frame: From enrollment till the end of treatment (two years from commencing treatment), every three months both questionnaires will be sent.
Hospital Anxiety and Depression Scale (HADS) is designed to assess symptoms of anxiety and depression in clinical and research settings. It consists of 14 items divided into two subscales: anxiety (HADS-A) and depression (HADS-D), each containing seven items scored on a 4-point Likert scale. Scores from 0-21 for each subscale, higher scores means greater distress.
From enrollment till the end of treatment (two years from commencing treatment), every three months both questionnaires will be sent.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

University Medical Center Groningen

Investigators

  • Principal Investigator: M. Jalving, University Medical Center Groningen

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

May 11, 2026

Primary Completion (Estimated)

May 1, 2030

Study Completion (Estimated)

February 1, 2039

Study Registration Dates

First Submitted

January 5, 2026

First Submitted That Met QC Criteria

June 11, 2026

First Posted (Actual)

June 12, 2026

Study Record Updates

Last Update Posted (Actual)

June 12, 2026

Last Update Submitted That Met QC Criteria

June 11, 2026

Last Verified

May 1, 2026

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 22590

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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