International Journal of Clinical Case Reports, 2025, Vol.15, No.3, 139-147 http://medscipublisher.com/index.php/ijccr 143 The results were clear. People who got both treatments lived longer. Their average survival time went from 13.3 months to 17.0 months (HR 0.71; p=0.003 5). The time before the cancer got worse also increased-from 5.9 months to 8.2 months (HR 0.68; p<0.01). More patients saw their tumors shrink-rising from 36% to 48%. But stronger side effects were seen. About 25% had high blood pressure. Around 6% developed gut fistulas (Mauricio et al., 2021). Another trial, KEYNOTE-158, looked at pembrolizumab. This drug blocks PD-1. It was given to people with PD-L1-positive cervical cancer. In this Phase II study, 14.3% of patients had tumors that shrank. And 91% of those people kept the benefit for at least 6 months (Chung et al., 2021). But only some patients got better. That’s why new combos are being tested. One new trial is BEATcc. It mixes three drugs-an anti-VEGF drug, an immune drug, and chemo. Early results look hopeful. Drugs reach tumors better, and immune cells work harder (Girma et al., 2021). 4.2 Case studies Real cases help us see how these combos work in real life. One report talked about a 45-year-old woman with metastatic cervical cancer. She got bevacizumab, cisplatin, and paclitaxel. Her tumor got much smaller. She stayed stable for 9 months. But she had high blood pressure and protein in her pee. Doctors used other drugs to manage this (Liontos et al., 2019). Another case was a 52-year-old woman with PD-L1-positive cervical cancer. She was given pembrolizumab. Her tumor shrank and stayed that way for 12 months. She also felt better. But her thyroid slowed down, so she needed hormone pills (Schmidt et al., 2022). In a third case, a woman had cancer that didn’t respond to platinum chemo. She then got a combo of bevacizumab and an immune drug. Her cancer didn’t grow for 8 months. Later, it came back. Doctors think this was due to mixed tumor types. Still, the combo helped for a while. 4.3 Comparison with monotherapy Many studies show that using two drugs together works better than using just one. In the GOG-240 study, people who got both lived 17 months. Those who got only chemo lived 13.3 months. Earlier studies say chemo alone gives about 8~12 months of life (Dyer et al., 2020). Other tests show similar results. If only pembrolizumab or bevacizumab is used, the cancer stays under control for 2–3 months. With both used together, it can last 8–10 months. Quality of life matters too. People on combo treatment often feel just as good, or even a little better. That’s because pain and bleeding get better. But combos have risks too. Problems like high blood pressure, gut issues, and immune side effects can happen. These must be managed carefully. So, while combo treatments do more, doctors have to pick the right patients. Side effects also need close watching. 5 Benefits and Limitations of Combination Therapy 5.1 Improved outcomes Using targeted drugs and chemo together helps people with late-stage cervical cancer. One big improvement came when doctors added bevacizumab (a drug that blocks new blood vessels) to platinum chemo. In the GOG-240 trial, patients who got this mix lived longer. Their average survival went up from 13.3 months to 17.0 months. They also went longer without the cancer getting worse-5.9 months with chemo alone versus 8.2 months with the combo (Kumar et al., 2018). Immune drugs like pembrolizumab also give good results. It helps people whose tumors are PD-L1-positive. In the KEYNOTE-158 trial, around 14.3% of patients saw their tumors get smaller. Many of them stayed in better shape for over a year (Mauricio et al., 2021). These findings show that using drugs together can help patients live longer and deal with their cancer more effectively. 5.2 Toxicity and side effects Combo treatments can help, but they can also cause more side effects. This makes it harder for some people to keep taking the drugs. Bevacizumab caused problems in the GOG-240 trial. Around 27% of patients got high
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