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

24 juni 2026 uppdaterad av: 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

Studieöversikt

Status

Rekrytering

Betingelser

Intervention / Behandling

Studietyp

Interventionell

Inskrivning (Beräknad)

261

Fas

  • Fas 4

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studiekontakt

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Studieorter

  • Nederländerna
      • Amsterdam, Nederländerna
      • Amsterdam, Nederländerna
        • Har inte rekryterat ännu
        • Antoni Van Leeuwenhoek Ziekenhuis
        • Kontakt:
        • Huvudutredare:
          • M. A. Rijlaarsdam
      • Eindhoven, Nederländerna
      • Enschede, Nederländerna
        • Har inte rekryterat ännu
        • Medisch Spectrum Twente
        • Kontakt:
        • Huvudutredare:
          • A. N.M. Wymenga
      • Groningen, Nederländerna, 9713 GZ
        • Rekrytering
        • University Mecdical Center Groningen
        • Kontakt:
        • Kontakt:
        • Huvudutredare:
          • M. Jalving, MD, PhD
      • Leiden, Nederländerna
        • Rekrytering
        • LUMC
        • Kontakt:
        • Huvudutredare:
          • J. R. Kroep
      • Maastricht, Nederländerna
        • Har inte rekryterat ännu
        • Maastricht UMC
        • Kontakt:
        • Huvudutredare:
          • A. J.M. Beijers
      • Nijmegen, Nederländerna
      • Rotterdam, Nederländerna
        • Har inte rekryterat ännu
        • Erasmus MC
        • Kontakt:
        • Huvudutredare:
          • I. A. Boere
      • Utrecht, Nederländerna
      • Zwolle, Nederländerna
        • Har inte rekryterat ännu
        • Isala Klinieken
        • Kontakt:
        • Huvudutredare:
          • W. A. van der Steeg

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

  • Vuxen
  • Äldre vuxen

Tar emot friska volontärer

Nej

Beskrivning

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:

    1. 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
    2. Immune-related toxicity grade ≥ 3 OR
    3. Patient's preference (e.g. chronic or invalidating grade 1-2 immune-related toxicity) OR
    4. 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.

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Behandling
  • Tilldelning: Icke-randomiserad
  • Interventionsmodell: Parallellt uppdrag
  • Maskning: Ingen (Open Label)

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Inget ingripande: 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.
Experimentell: 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.
Läkemedel: 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).

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Evaluate the progression-free survival (PFS) and compare to the KEYNOTE-826 trial
Tidsram: 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

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Evaluate progression-free survival (PFS) at 12- and 24 months
Tidsram: 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)
Tidsram: 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)
Tidsram: 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)
Tidsram: 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
Tidsram: 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.
Tidsram: 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
Tidsram: 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
Tidsram: 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.

Samarbetspartners och utredare

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Sponsor

University Medical Center Groningen

Utredare

  • Huvudutredare: M. Jalving, University Medical Center Groningen

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Faktisk)

11 maj 2026

Primärt slutförande (Beräknad)

1 maj 2030

Avslutad studie (Beräknad)

1 februari 2039

Studieregistreringsdatum

Först inskickad

5 januari 2026

Först inskickad som uppfyllde QC-kriterierna

11 juni 2026

Första postat (Faktisk)

12 juni 2026

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

29 juni 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

24 juni 2026

Senast verifierad

1 maj 2026

Mer information

Termer relaterade till denna studie

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • 22590

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