Immunotherapy for Cervical Cancer

Learn how immunotherapy helps prevent and treat cervical cancer

What Is Cervical Cancer?

Cervical cancer is the fourth most common cancer in women worldwide, with about 660,000 new cases diagnosed and 350,000 deaths each year. In the U.S., an estimated 13,360 new cases and 4,320 deaths are expected in 2025.

Almost all cases of cervical cancer are linked to infection with human papillomavirus (HPV), a common virus that can also cause anal, genital, and certain head and neck cancers. Most people infected with HPV do not develop cancer, but persistent infection with certain types of HPV increases risk.

Cervical cancer begins in the cells of the cervix, the lower part of the uterus that connects to the vagina. It usually develops slowly over time, starting with abnormal cell changes that can progress to cancer if left untreated. Most cervical cancers start in the outer cells of the cervix (squamous cell carcinoma), while others begin in glandular cells (adenocarcinoma), and in some cases, it can have features of both types (mixed or adenosquamous carcinoma).

Early detection and prevention through HPV vaccination play an important role in reducing cervical cancer risk. When cervical cancer is detected early — before it spreads — the five-year survival rate is 91%. Once the cancer has spread to nearby tissues, five-year survival rates drop to 60%, and down to 19% when it has spread to distant parts of the body. When a person is vaccinated before being exposed to HPV, the HPV vaccine is 97% effective in preventing cervical cancer.

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What is Cervical Cancer Screening, and How is Cervical Cancer Detected?

Cervical cancer screening can help detect cancer early, before symptoms appear. Common types of cervical cancer screening include:

• Pap smear (also called a Pap test): A test that collects cells from the cervix to check for abnormal changes.
• HPV testing: A DNA test that identifies high-risk HPV types linked to cervical cancer.

Widespread use of Pap testing has significantly reduced cervical cancer deaths in the U.S., but incidence and mortality remain much higher in many low-income countries.

Below are general cervical cancer screening guidelines for individuals with a cervix according to the U.S. Centers for Disease Control and Prevention (CDC):

What Are the Symptoms of Cervical Cancer?

Cervical cancer often has no symptoms in its early stages. When symptoms do appear, the most common is abnormal vaginal bleeding. Some people may also experience pelvic pain or unusual discharge, but symptoms can overlap with other conditions – this is another reason why regular screening is so important.

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Can Cervical Cancer Be Prevented?

Cervical cancer is highly preventable through regular screenings and HPV vaccination. Since the first HPV vaccine was introduced in 2006, new cases of cervical cancer in the U.S. have dropped significantly. Widespread vaccination has proven to be one of the most effective tools for preventing cervical cancer, and countries such as Australia and Sweden are now on track to eliminate cervical cancer as a public health problem through strong vaccination and screening programs.

In the U.S., the following vaccines are approved to prevent HPV infection and cervical cancer:

• Gardasil®: A vaccine that protects against four HPV types (6, 11, 16, and 18). It helps prevent HPV-related cervical, vulvar, vaginal, and anal cancers.
• Gardasil-9®: A vaccine that protects against nine HPV types (6, 11, 16, 18, 31, 33, 45, 52, and 58). These types cause approximately 90% of cervical cancers and 90% of genital warts, making Gardasil-9 the broadest protection currently available.

The foundational research that helped make these HPV vaccines possible was first supported by CRI in 1999. Recent research suggests that vaccination may provide some protection in people previously exposed to HPV, even though these vaccines do not treat existing cancers. Gardasil and Gardasil-9 are most effective when given before HPV exposure, typically in adolescence.

Who Should Get the HPV Vaccine?

The U.S. CDC recommends HPV vaccination based on age:

How Is Cervical Cancer Treated?

Cervical cancer can be treated in several ways, depending on the stage of disease and a patient’s overall health. Standard treatment options include surgery, radiation therapy, chemotherapy, targeted therapy, and immunotherapy. Immunotherapy is a standard treatment option for some patients, particularly those with advanced or recurrent disease.

Immunotherapies Used to Treat Cervical Cancer

Immunotherapy is a type of cancer treatment that uses your body’s immune system to recognize and attack cancer cells. It works by helping your immune system overcome cancer’s defenses, enabling immune cells to better identify and fight the disease. 


• Pembrolizumab (Keytruda®): An immune checkpoint inhibitor (ICI) that targets the PD-1/PD-L1 pathway with three approved uses in cervical cancer:
  • In combination with chemoradiotherapy for newly diagnosed FIGO 2014 stage III-IVA cervical cancer (approved January 2024)
  • In combination with chemotherapy, with or without bevacizumab, for persistent recurrent, or metastatic cervical cancer with PD-L1 expression (CPS≥1) (approved October 2021)
  • As monotherapy for recurrent or metastatic cervical cancer with PD-L1 expression (CPS≥1) after disease progression on or after chemotherapy (approved June 2018)

Targeted Antibodies Used to Treat Cervical Cancer

Targeted antibodies are a type of cancer treatment that can disrupt cancer cell activity and alert the immune system to target and eliminate cancer cells. Unlike chemotherapy and radiation — which affect both cancerous and healthy cells — these antibodies are designed to target specific features involved in cervical cancer growth and spread.

• Bevacizumab (Avastin®): A monoclonal antibody that targets the VEGF/VEGFR pathway to prevent tumor blood vessel growth. It is approved for certain patients with advanced cervical cancer when used in combination with chemotherapy.
• Tisotumab vedotin (Tivdak™): An antibody-drug conjugate that targets a protein called tissue factor. It is approved for patients with recurrent or metastatic cervical cancer that has progressed after chemotherapy.

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Are There Clinical Trials for Patients with Cervical Cancer?

If standard treatments for patients with cervical cancer haven’t worked or are not available, clinical trials may offer access to promising new therapies. Clinical research is progressing across several types of immunotherapies:

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How Is CRI Advancing Cervical Cancer Research?

CRI funds many types of cervical cancer research – from early laboratory discoveries to innovative clinical studies. Our support has helped scientists and clinicians uncover how HPV evades the immune system, understand immune responses in HPV-related cancers, and develop new ways to monitor vaccine effectiveness.

In 1999, CRI awarded the first of several grants to Ian H. Frazer, MD, FRCPA, for his pioneering work on virus-like particles (VLPs) – a critical technology that made Gardasil possible and protected millions of people worldwide.

Today, CRI continues to support scientists exploring ways to boost immunity after treatment, identify novel targets for next-generation CAR T-cell therapies, and isolate HPV-specific immune cells to guide future interventions. These investments lay the groundwork for promising advances in the field, including therapeutic vaccines and combination immunotherapy approaches, offering new hope for patients facing cervical cancer.