Final overall survival (OS) results from BEATcc (ENGOT-Cx10/GEICO 68- C/JGOG1084/GOG-3030), a randomised phase 3 trial of first-line atezolizumab (atezo), chemotherapy (CT) and bevacizumab (bev) for metastatic, persistent or recurrent cervical cancer (R/M CC)

BEATcc

Patient / Population Intervention / Exposition Vergleich Endpunkt

In patients with metastatic, persistent or recurrent cervical cancer, adding atezolizumab to first-line chemotherapy plus bevacizumab improved overall survival at the final analysis compared with chemotherapy plus bevacizumab alone.

N

410Patienten

Design

Randomised 1:1 phase 3 trial in patients with previously untreated measurable metastatic, persistent or recurrent cervical cancer not amenable to curative surgery or radiation, comparing standard chemotherapy plus bevacizumab with or without atezolizumab, stratified by previous concomitant chemoradiation, histological subtype and chemotherapy backbone (NCT03556839; EudraCT 2018-000367-83).

Endpunkt

Dual primary endpoints of progression-free survival and overall survival. This final analysis reports overall survival, prespecified after ≥292 deaths or 4 years after last patient enrolment, whichever occurred first.

ErgebnisOverall survival HR 0.69 (95% CI 0.54-0.88) with atezolizumab added to chemotherapy plus bevacizumab. Median overall survival 31.9 vs 22.7 months, and 4-year overall survival 40% vs 26% with vs without atezolizumab. Median follow-up 57.2 months (95% CI 54.9-59.5), with 277/410 (68%) patients dead. PFS2 HR 0.62 (95% CI 0.49-0.78; median 23.3 vs 17.0 months). Exploratory overall survival by PD-L1 status: HR 0.71 (95% CI 0.50-0.99; median 32.7 vs 26.5 months) in PD-L1+ (CPS ≥1) and HR 0.53 (95% CI 0.32-0.88; median 38.6 vs 19.2 months) in PD-L1– (CPS <1). Long-term safety was generally consistent with the primary analysis.

Oaknin A, Leary A, Martinez-Garcia J, et al. Presented at ESMO Congress 2026, abstract LBA38, 24 October. Not yet published.

Diskussion & Kritik

With nearly five years of median follow-up, the overall survival benefit seen at the interim analysis held up at the final analysis, and post-progression outcomes measured by PFS2 also favoured atezolizumab. Crossover was not permitted, but 64 (58%) of the 110 control patients who received post-progression therapy were given immunotherapy, which would be expected to narrow rather than widen the gap. The PD-L1 subgroup results are exploratory, the PD-L1– subgroup has a wide confidence interval, and the abstract gives no P value for the final overall survival comparison. The abstract does not state whether treatment was blinded, and it describes long-term safety only in qualitative terms, with no adverse event rates.