Enhancing Survival in Endometrial Cancer: Impact of Immunotherapy and Chemotherapy Combination Therapy
Immunotherapy in combination with chemotherapy shows promise as a first-line treatment for advanced endometrial cancer, particularly for patients with mismatch repair deficiency (MMRd), leading to improved progression-free survival and overall survival outcomes, according to research published in Annals of Oncology.
Advances in immunotherapy have revolutionized the treatment of endometrial cancer, particularly in cases with mismatch repair deficiency. Evidence suggests that combining immunotherapy with chemotherapy is an effective first-line treatment approach. Ongoing trials such as RUBY, NRG-GY018, AtTEnd, and DUO-E are providing valuable insights into the role of immunotherapy in advanced or recurrent endometrial cancer.
Data from 2320 patients in trials support combining chemotherapy with immunotherapy, resulting in improved progression-free survival compared to chemotherapy alone across all patient groups (HR, 0.70; 95% CI, 0.62-0.79). The greatest progression-free survival benefits were seen in MMRd and microsatellite instability-high (MSI-H) tumors (n = 563; HR, 0.33; 95% CI, 0.23-0.43), but benefits were also observed in MMR-proficient/microsatellite-stable tumors (n = 1757; HR, 0.74; 95% CI, 0.60-0.91).
Pooled data also show that chemotherapy plus immunotherapy leads to better overall survival compared with chemotherapy alone for all patients (HR, 0.75; 95% CI, 0.63-0.89), though more data is needed to fully evaluate this outcome.
“The incorporation of immunotherapy into the initial treatment for advanced and metastatic endometrial cancer brings about a substantial improvement in oncologic outcomes, especially within the MMRd/MSI-H subset,” researchers said. “This specific subgroup is currently a focal point of investigation for evaluating the potential of chemotherapy-free regimens. Ongoing exploratory analyses aim to identify non-responding patients eligible for inclusion in clinical trials.”
Reference
Bogani G, Monk B J, Powell M A, et al. Adding immunotherapy to first-line treatment of advanced and metastatic endometrial cancer. Ann Oncol. 2024;35(5):414-428. doi: 10.1016/j.annonc.2024.02.006.
