Iparomlimab/Tuvonralimab Injection Plus CCRT in LACC

Inclusion criteria

• Informed consent.

• Female patients aged ≥18 years and ≤ 75 years at time of inform consent signature

• Has an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1

• Expected survival ≥ 3 months

• Patients must have histologically confirmed diagnosis of HPV-related cervicalsquamous, or adenocarcinoma, or adenosquamous carcinoma

• FIGO 2018 stage T3a-4a (III-IVA), N1 (positive lymph node metastasis on CT/MRI withshort-axis ≥1 cm, or PET-CT showing one or more lymph node metastases with SUVmax ≥2.5), M0

• Has at least one evaluable disease per RECIST 1.1

• Has adequate organ function

• Hematology: ANC ≥1.5 ×10⁹/L; platelets ≥100 ×10⁹/L; hemoglobin ≥90 g/L (noblood transfusion or growth factor support within 7 days)

• Renal: CrCl ≥50 mL/min (Cockcroft-Gault formula), urine protein <2+ or 24h <1.0g

• Hepatic: Total bilirubin ≤1.5×ULN; AST and ALT ≤2.5×ULN

• Coagulation: INR and APTT ≤1.5×ULN

• Cardiac: LVEF ≥50%

• Women of childbearing potential: a negative urine or serum pregnancy test within 3days prior to the first dose of study drug (if the urine pregnancy test resultcannot be confirmed as negative, a serum pregnancy test must be performed, and theserum result will be considered definitive).If a female participant of childbearingpotential engages in sexual activity with a male partner who is not surgicallysterile, she must use an acceptable method of contraception starting from screeningand agree to continue using the same contraception for 120 days after the last doseof study drug. Whether to discontinue contraception after this period should bediscussed with the investigator

• Willingness to comply with the study procedures before study entry

Main Exclusion Criteria:

• Cervical cancer of other histology (e.g., neuroendocrine carcinoma, sarcoma)

• Evidence of distant metastasis

• Prior total hysterectomy (subtotal or cervical-sparing surgery allowed)

• Unable or unwilling to receive brachytherapy

• Prior treatment with immune checkpoint inhibitors or other tumor immunotherapy

• Systemic corticosteroid (>10 mg/day prednisone or equivalent) or immunosuppressivetherapy within 2 weeks (exceptions: inhaled/topical ≤10 mg/day, physiologicreplacement ≤10 mg/day, premedication for hypersensitivity).

• Immunomodulatory drugs within 2 weeks (e.g., thymosin, interferons, IL-2)