A Changing Landscape in First-Line Endometrial Cancer

The buzz created by two phase III studies testing immunotherapy in advanced or recurrent endometrial cancer at the Society of Gynecologic Oncology (SGO) annual meeting earlier this year carried over to the recent American Society of Clinical Oncology (ASCO) meeting.

At ASCO, physicians were still talking about how the NRG-GY018 and RUBY trials will change the future of treatment for these patients, along with the implications for second-line care. In this exclusive MedPage Today video, Alessandro Santin, MD, of Yale University School of Medicine in New Haven, Connecticut, discusses what we know about the results and what is still left to be determined.

Following is a transcript of his remarks:

The presentation a month ago at SGO, so GY018 and RUBY, they’ve changed the picture, because this dramatic increase in response — in particular increasing progression-free survival — adding immune checkpoint inhibitor to our carboplatin and paclitaxel chemotherapy backbone has most likely changed the future guidelines.

Currently, we don’t know if the FDA is going to approve the use of carboplatin and paclitaxel plus the immune checkpoint inhibitor — either dostarlimab [Jemperli] or pembrolizumab [Keytruda] — in all patients with endometrial cancer, namely both MMR [mismatch repair]-deficient as well as MMR-proficient.

What we know is that patients with endometrial cancer with deficiency in mismatch-repair gene are exquisitely sensitive to immune checkpoint inhibitor, and that is why we are seeing this dramatic difference when immune checkpoint was combined upfront to chemotherapy versus the chemotherapy standard control arm.

But how this type of finding is going to affect [the] endometrial cancer population as a whole, we still don’t know because the FDA has not deliberated yet.