Immunotherapy and Chemotherapy for Advanced or Recurrent Endometrial Carcinoma

Abstract

Patients with early-stage endometrial cancer are frequently treated with surgery and radiotherapy or chemotherapy, for which 5-year survival rates approach 95%; conversely, the outcomes for patients with advanced or recurrent endometrial cancer are more inauspicious. Fortunately, the advent of immunotherapy, combined with chemotherapy, has conferred improved survival, especially in endometrial cancer patients with a mismatch repair deficiency (dMMR). We conducted an extensive PubMed search on the topics of endometrial cancer and immunotherapy treatment. The combination of dostarlimab and chemotherapy reportedly coincides with a 2-year progression-free survival (PFS) of 61% compared to a 12-month PFS of 74% for pembrolizumab. Moreover, the follow-up data for dostarlimab extended beyond 44 months and the median overall survival (OS) has not been reached compared to more limited OS data for both pembrolizumab and durvalumab; additionally, dostarlimab's pronounced risk of disease progression or death in both dMMR (70%) and mismatch repair-proficient (pMMR) (46%) patients is considerable. While pembrolizumab, dostarlimab and durvalumab with chemotherapy are associated with beneficial outcomes in advanced-stage or recurrent endometrial cancer, dostarlimab has distinguished itself with unsurpassed survival data compared to pembrolizumab and durvalumab.

Keywords: Endometrial cancer; chemotherapy; immunotherapy; mismatch repair status; outcomes; review; tolerability.