[French recommendations for clinical practice, Nice-Saint-Paul de Vence 2024-2025: Management of advanced cervical cancer].

During decades, first-line treatment of advanced cervical cancer solely consisted of platinum-based chemotherapy, associated with bevacizumab whenever possible. Since 2022, immunotherapy is part of standard therapeutic strategy with pembrolizumab on the one hand, associated with chemotherapy and bevacizumab in patients with PD-L1 positive tumors (CPS≥1), and cemiplimab on the other hand, in patients who did not receive prior immunotherapy and progress after first line regardless of PD-L1 expression. Pretherapeutic work-up includes CT of the chest, abdomen and pelvis potentially associated with 18F-FDG PET-CT and MRI in case of relapse, as well as evaluation of PD-L1 status on tumor and immune cells to define the CPS score that will determine eligibility to pembrolizumab treatment (CPS≥1). Whenever possible, molecular screening and determination of HER2 status may allow orienting patients to clinical trials. Indeed, inclusion in investigational studies must be systematically considered and early supportive care is always recommended.