NICE recommends MSD’s KEYTRUDA® (pembrolizumab) with chemoradiotherapy (external beam radiation therapy followed by brachytherapy) , within its marketing authorisation, as an option for untreated International Federation of Gynaecology and Obstetrics (FIGO) 2014 stages 3 to 4A locally advanced cervical cancer (LACC) in adults
June 25, 2026 – –
LONDON, 25th June 2026 – MSD (tradename of Merck & Co., Inc., Rahway, N.J., USA (NYSE: MRK)) today welcomes news that the National Institute for Health and Care Excellence (NICE) has recommended the use of KEYTRUDA® (pembrolizumab), within its marketing authorisation, as an option for patients with untreated FIGO 2014 stage III-IVA locally advanced cervical cancer (LACC) over a two-year treatment regimen.i
While recent progress in treatment for LACC has primarily involved refining radiation and chemotherapy, the approval of pembrolizumab represents a new development in the standard of care for patients with stage III–IVA locally advanced cervical cancer.ii,iv
Pembrolizumab, in combination with CRT (external beam radiation therapy followed by brachytherapy), is indicated for the treatment of FIGO 2014 Stage III–IVA locally advanced cervical cancer in adults who have not received prior definitive therapy. NICE recommends pembrolizumab in combination with the current standard of care, chemoradiotherapy (CRT), followed by pembrolizumab monotherapy for a total treatment duration of 2 years, administered either intravenously or subcutaneously (via an injection under the skin).i
Cervical cancer grows from abnormal cells in the lining of the cervix.[vi] While most prevalent in women aged 30 to 35, the disease can affect women of any age.[vii] Driven in nearly all cases by high-risk strains of the Human Papillomavirus (HPV), cervical cancer typically develops slowly.vii It is the 14th most common cancer for women in the UK,[viii] and there are around 3,300 new cases of cervical cancer are diagnosed each year in the UK.[ix]
Around 40% of patients with Stage III cervical cancer will survive their cancer for 5 years or more after diagnosis; at Stage IV, this is reduced to around 15%.[x] In the UK, cervical cancer is often seen in women who have faced limited access to early detection and preventative care.[xi] This includes women who may face practical and emotional barriers like inconvenient clinic hours, transport issues, cultural determinants, and feelings of fear or embarrassment.xi Black African, Asian and migrant women in the UK, in particular, have lower screening participation due to a range of factors including language barriers, cultural stigma around the procedure, or a lack of representation in healthcare messaging.[xii]
LACC is defined as a disease in stages ranging from IB3 to IVA[xiii], which means the cancer has spread beyond the cervix to surrounding organs and spread further through the lymphatic system to nearby and more distant lymph nodes and, in some cases, spread through the bloodstream to adjacent pelvic organs.[xiv] Chemoradiotherapy (CRT) is the current standard of care for LACC in England.iv
Louise Broadbelt, cervical cancer patient said:
“Nothing can prepare you for being diagnosed with cancer. All you want to hear is you will get the best possible treatment and have hope.
“I’m very grateful that I was offered the chance to go on the pembrolizumab clinical trial in 2021 when I was diagnosed with Stage III locally advanced cervical cancer whilst under the care of The Royal Marsden Hospital and my wonderful oncologist Dr Susan Lalondrelle.
“I feel incredibly blessed and lucky that I was offered to participate in the trial and that I am still here today and the results may help others.”
Dr. Alexandra Taylor, Consultant in Clinical Oncology at The Royal Marsden said:
“This approval marks an important milestone for women with stage III-IVa locally advanced cervical cancer. It is encouraging that more patients will now have access to a treatment that can genuinely improve their long-term outcomes.”
John McNeill, Oncology Business Unit Director at MSD in the UK said:
“We welcome today’s recommendation from NICE, which is an important step forward for women living with locally advanced cervical cancer.
This is a cancer which disproportionately impacts women from underserved backgrounds and where there has long been an unmet need. Today’s decision represents a meaningful development for these patients, who may benefit from additional treatment options.”
NICE’s decision is based on results from the Phase 3, randomised, double-blind KEYNOTE-A18 (KN-A18) trial, which examined the addition of pembrolizumab to CRT for newly-diagnosed, high-risk, LACC.ii
The primary end points of the trial were progression-free survival (PFS) and overall survival (OS) in the intention-to-treat (ITT) population.ii The main objective of the study was to understand whether the addition of pembrolizumab to CRT resulted in patients living longer without their cancer getting worse, and that this was measured across all randomly-selected participants. The trial results that support the marketing authorisation are from a subgroup exploratory analysis. Significance was not tested in the stage III-IVA subgroup; therefore, no statistical conclusions can be drawn from this analysis. The results for the ITT population are referenced as this is the primary endpoint of the study. This approach allows the results in the licensed population (a subgroup of the ITT population) to be viewed in context of the primary endpoint.
[vi] CRUK, What is cervical cancer?, Cancer Research UK. (Accessed June 2026).
[vii] NHS NHS choices – What is cervical cancer? 2025 (Accessed June 2026).
[viii] NICE. Cervical cancer and HPV:How common is it? 2025. (Accessed June 2026).
[ix] CRUK, Cervical cancer statistics, Cancer Research UK (Accessed June 2026).
[x] CRUK, Survival for cervical cancer Cervical cancer survival, Cancer Research UK. (Accessed June 2026).
[xi] Choi S, Ismail A, Pappas-Gogos G, Boussios S. HPV and Cervical Cancer: A Review of Epidemiology and Screening Uptake in the UK. Pathogens. 2023 Feb 11;12(2):298. doi: 10.3390/pathogens12020298. PMID: 36839570; PMCID: PMC9960303.
[xii] Forward UK Barriers to accessing cervical cancer screening: Voices from women survivors of Female Genital Mutilation (FGM). 2025. (Accessed June 2026).
[xiii] How JA, Jazaeri AA. Immunotherapy in locally advanced cervical cancer: Integrating KEYNOTE-A18 into management strategies. Med. 2024 Jun 14;5(6):487-489. doi: 10.1016/j.medj.2024.05.001. PMID: 38878765; PMCID: PMC12004455.
[xiv] Zhou, Y. et al. (2022) ‘Current standards in the management of early and locally advanced cervical cancer: Update on the benefit of Neoadjuvant/adjuvant strategies’, Cancers, 14(10), p. 2449. doi:10.3390/cancers14102449.
About MSD
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