Immunotherapy as a treatment strategy in advanced stage and recurrent endometrial cancer: review of current phase III immunotherapy clinical trials

Abstract

The treatment of advanced stage, metastatic or recurrent endometrial cancer remains a clinically difficult scenario. Although combination carboplatin and paclitaxel is an effective standard-of-care regimen, alternate strategies have shown promise, particularly in biomarker select populations. In an effort to improve oncologic outcomes, investigators are exploring novel immunotherapy combinations. In this review, we discuss the clinical rationale and design of current phase III immuno-oncology clinical trials in patients with advanced stage or recurrent endometrial cancer.

PD-L1 Expression in Endometrial Cancer and Its Association with Clinicopathological Features: A Systematic Review and Meta-Analysis

“…The preliminary results reported by the American Society of Clinical Oncology showed that atezolizumab and pembrolizumab might have promising outcomes in the treatment of endometrial cancer. To date, six clinical trials are in active ongoing phase III combination immunotherapy trials in patients with advanced stage and recurrent EC [ 62 , 63 ]. In addition, more data have demonstrated that cytotoxic drugs and targeted therapies influence immune responses [ 17 , 61 ].…”

Previously treated recurrent or advanced endometrial cancer in England: A real-world observational analysis

“…With manageable safety profiles reported for both regimens [9,12,21,22,34], these data suggest that immune checkpoint inhibitors could achieve improved survival outcomes for patients with recurrent or advanced endometrial cancer in the post-platinum setting. With these recent approvals in the second-line setting, there is now considerable interest with regards to immunotherapy in the first-line setting, either as monotherapy or in combination with a variety of treatment agents, with a number of Phase III randomised trials initiated [35][36][37][38][39][40]. These may offer further treatment options for women with recurrent or advanced endometrial cancer in the future.…”

Treatment patterns and real-world clinical outcomes in patients with advanced endometrial cancer that are non-microsatellite instability high (non-MSI-high) or mismatch repair proficient (pMMR) in the United States

“…Based on these estimates, the prevalence of non-MSI-H tumors appears to be roughly 69–75% for aEC patients in the US. Recent approval of treatments focusing on DNA mismatch repair tumor status have changed the treatment landscape in patients with advanced or recurrent EC ( Eskander and Powell, 2021 , Makker et al, 2017 , Gehrig and Bae-Jump, 2010 ). In September 2019, the US Food and Drug Administration (FDA) granted accelerated approval for pembrolizumab and lenvatinib combination therapy for patients with aEC that was non-MSI-H or was proficient MMR (non-MSI-H/pMMR), and in July 2021 granted full approval ( Center for Drug Evaluation and Research, 2021 , Center for Drug Evaluation and Research, 2020 ).…”