Latest advances in immuno-oncology for endometrial cancer: single-agent and combination regimens

Curr Opin Obstet Gynecol. 2024 Feb 1;36(1):1-8. doi: 10.1097/GCO.0000000000000917. Epub 2023 Sep 28.

Abstract

Purpose of review: The scope of immuno-oncology in endometrial cancer has changed rapidly in the last several years, requiring up-to-date knowledge for those who treat these patients.

Recent findings: This article will focus on molecular profiling, recent trials, and FDA approvals of targeted immuno-oncology medications in endometrial cancer. These include immune checkpoint inhibitors alone or with combination treatment.

Summary: The publication of the TCGA has led to significant focus on molecular subgroupings into POLEm, MMRd, NSMP, and p53m groups. For those patients with MMRd vs. MMRp tumors, there are indications for single agent immune checkpoint inhibitors with dostarlimab or pembrolizumab. For those with MMRp tumors, the addition of lenvatinib to pembrolizumab has proven clinical benefit. The recent publication of the RUBY and NRG-GY018 trials have shown clinical benefit in both subgroups with addition of immune checkpoint inhibitor to platinum-based chemotherapy. Now there is approval for use of dostarlimab in frontline chemotherapy and maintenance for advanced stage or recurrent endometrial cancer. Several upcoming trials investigating molecular subgroups from the TCGA are eagerly anticipated.

Publication types

  • Review

MeSH terms

  • Combined Modality Therapy
  • Endometrial Neoplasms* / drug therapy
  • Endometrial Neoplasms* / pathology
  • Female
  • Humans
  • Immune Checkpoint Inhibitors* / therapeutic use
  • Neoplasm Recurrence, Local / drug therapy

Substances

  • Immune Checkpoint Inhibitors