Cervical Cancer, Version 2.2026, NCCN Clinical Practice Guidelines In Oncology
- Study type
- Clinical guideline
- Study name
- NCCN Cervical Cancer v2.2026
- Design
- Clinical guideline of the US National Comprehensive Cancer Network (NCCN); recommendation categories: category 1 (high-level evidence and uniform consensus), category 2A (lower-level evidence and uniform consensus)
- Source
- J Natl Compr Canc Netw · 2025
In plain words
The NCCN guidelines are among the most widely cited cancer treatment guidelines in the world and are updated regularly. Version 2.2026 includes the newest proven treatments for cervical cancer, including adding immunotherapy to chemoradiotherapy in locally advanced disease and using tisotumab vedotin after the first treatment has stopped working.
Key guideline recommendations
- Category not stated in the text
Concurrent chemoradiotherapy is usually the primary treatment of choice for stages IB3 to IVA; single-agent cisplatin is the preferred radiosensitising agent, and carboplatin is preferred in patients intolerant of cisplatin.
- Category not stated in the text
Based on the KEYNOTE-A18 trial, pembrolizumab may be added to chemoradiotherapy in selected patients with FIGO 2014 stage III–IVA disease.
- Category not stated in the text
Based on the INTERLACE trial, induction chemotherapy followed by chemoradiotherapy has been included as a footnote in the systemic therapy recommendations for patients with stage IIB–IVA disease.
- Category 1, preferred
Pembrolizumab with chemotherapy, with or without bevacizumab, is a preferred first-line option for PD-L1-positive recurrent or metastatic cervical cancer (based on KEYNOTE-826).
- Category 1, preferred
Atezolizumab with the GOG240 chemotherapy and bevacizumab regimen has been added to the preferred first-line regimens based on the BEATcc results.
- Category 2A
Carboplatin/paclitaxel/bevacizumab has been included as another preferred regimen for recurrent or metastatic cervical cancer.
- Preferred (category not stated in the text)
Tisotumab vedotin is a preferred option for recurrent/metastatic cervical cancer with disease progression on or after chemotherapy, regardless of biomarker status.
- Category 1
Postoperative external-beam pelvic radiotherapy is recommended for patients with stage IA or IB node-negative disease who have a large primary tumour, deep stromal invasion and/or lymphovascular space invasion (GOG/Sedlis criteria); and pelvic radiotherapy with concurrent platinum chemotherapy for high-risk patients (positive pelvic nodes, positive surgical margins and/or parametrial involvement).
- Category 1
For stage IB1 (not meeting criteria for conservative surgery), IB2 and IIA1, primary surgery consists of type C1 radical hysterectomy with sentinel node mapping or bilateral pelvic lymphadenectomy.
Study population
Patients with cervical cancer: diagnostic workup, principles of staging and surgery, primary treatment of early-stage and advanced disease, and systemic therapy for recurrent or metastatic disease.
Clinical significance and place in guidelines
The most up-to-date comprehensive guideline available, incorporating the 2024 evidence (KEYNOTE-A18, INTERLACE, BEATcc, innovaTV 301). The full algorithms are updated on the NCCN website and may have changed since this published version.
Limitations
The NCCN guideline is developed for the US health system. The version published in the journal is a selected part of the full guideline.
This summary was prepared by the editorial team from the published paper; the original paper is the final reference. Read the original abstract on PubMed.