Multi-Region LLM Serving and KV Cache Locality

Round-robin load balancing is actively harmful for cached LLM inference. A request that does not land on the node holding its prefix pays full prefill cost — roughly 800 ms at P50 on a long prompt versus ~80 ms with a cache hit. In 2026 the production pattern is a cache-aware router (vLLM Router in Rust, llm-d router) that consumes KV-cache events and routes on prefix-hash match. Recent research (GORGO) makes cross-region network latency an explicit term in the routing objective. Commercial "cross-region inference" offerings (Bedrock cross-region inference, GKE multi-cluster gateways) treat inference as opaque — they handle availability, not TTFT. JPMorgan and Mayo Clinic ran us-east-1 failover in Nov 2024 at ~22 minutes. The DR reality: 32% of LLM DR failures are because teams backed up weights but forgot tokenizer files or quantization configs.