Researchers from the Moores Cancer Center at UC San Diego Health and the University of California San Diego School of Medicine found that when compared to chemotherapy alone, the combination of immunotherapy (pembrolizumab) and chemotherapy in patients with advanced or recurrent/advanced endometrial cancer resulted in a significant reduction in disease growth.
One of the few types of cancer that has a rising incidence and death rate is endometrial cancer, which starts in the lining of the uterus. By 2040, experts predict that it will be the third most common cancer and the fourth leading cause of cancer-related death among women.
In the beyond forty years, there have been restricted progressions in therapy for patients with cutting edge endometrial disease.
“These findings could change the way we treat patients with advanced stage or recurrent/advanced uterine cancer. Chemotherapy alone is currently utilized as the first-line treatment for people with this condition.”
Ramez N. Eskander, MD, associate professor in the Department of Obstetrics, Gynecology, and Reproductive Sciences.
“The way we treat patients with advanced, recurrent, or advanced uterine cancer may change as a result of these findings.” Ramez N. Eskander, MD, principal investigator and lead author of the study, stated, “Currently, chemotherapy alone is used as the first-line treatment for patients with this disease.” Eskander is an associate professor in the Department of Obstetrics, Gynecology, and Reproductive Sciences at the UC San Diego School of Medicine.
“To attack this cancer and give patients more time to live their lives to the fullest, it is critical that we work to identify effective and innovative treatments and combination therapies, such as immunotherapy and chemotherapy.”
816 individuals with Stage III or IV endometrial cancer were divided into two groups in the Phase III trial, which was blinded, placebo-controlled, and randomized. deficient mismatch repair (dMMR) and proficient mismatch repair (pMMR), which can be treated with chemotherapy alone or immunotherapy in combination with it.
Mismatch repair (MMR) proteins are used to describe cancerous cells that have mutations in particular genes involved in correcting errors made during DNA replication. pMMR is the “typical” express our cells are in, where the MMR pathway is dynamic and utilitarian. The “mutant” state of dMMR is one in which the MMR pathway does not function normally.
Participants who received immunotherapy in addition to chemotherapy showed a 70% decrease in the risk of disease progression at a 12-month follow-up in the dMMR group. Participants who received immunotherapy in addition to chemotherapy had a 46% lower risk of disease progression in the pMMR group.
According to Eskander, a gynecologic oncologist at UC San Diego Health, “These are exciting results that are both statistically significant and reflective of a clinically meaningful benefit.”
Each year, more than 60,000 new cases of endometrial cancer are discovered. Vaginal bleeding or spotting, pelvic pain, bloating, and changes in bowel or bladder habits are some of the symptoms.
Eskander emphasizes that postmenopausal women are more likely to develop endometrial cancer, and vaginal bleeding and spotting in this group of patients can sometimes be overlooked.
“Post-menopausal women who experience vaginal bleeding, even spotting, should consult their doctor. Better outcomes frequently result from early diagnosis.”
Eskander adds that the Food and Drug Administration’s approval and the adoption of the new treatment strategy as standard practice are the next steps in expanding on the study’s findings.
More information: Ramez N. Eskander et al, Pembrolizumab plus Chemotherapy in Advanced Endometrial Cancer, New England Journal of Medicine (2023). DOI: 10.1056/NEJMoa2302312. www.nejm.org/doi/10.1056/NEJMoa2302312
