Introduction
Molecular profiling and targeted treatment are the new approach in management of endometrial cancer.Immunotherapy has shown promising results in recurrent advanced previously treated endometrial cancer, but its role as a part of primary treatment is yet to be establised.
Methods
In this article we are reporting a case of MSI-H advanced endometrial cancer with Pembrolizumab as a third line therapy prior to attempting complete cytoreduction.
Results
Additon of Pembrolizumab resulted in complete response to treatment in a chemorefractory advanced endometrial cancer.
Conclusions
Immunotherapy is a viable novel therapeutic option to treat advanced endometrial cancer in select cases.
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References
Cook AM, Lodge N, Blake P. Stage IV endometrial carcinoma: a 10 year review of patients. Br J Radiol. 1999;72:485–8.
Khouri OR, Frey MK, Musa F, et al. Neoadjuvant chemotherapy in patients with advanced endometrial cancer. Cancer Chemother Pharmacol. 2019;84:281–5.
Bestvina CM, Fleming GF. Chemotherapy for endometrial cancer in adjuvant and advanced disease settings. Oncologist. 2016;21:1250–9. https://doi.org/10.1634/theoncologist.2016-0062.
Pardoll DM. The blockade of immune checkpoints in cancer immunotherapy. Nat Rev Cancer. 2012;12:252–64. https://doi.org/10.1038/nrc3239.
Sun Z, Fourcade J, Pagliano O, Chauvin JM, Sander C, Kirkwood JM, Zarour HM. IL10 and PD-1 cooperate to limit the activity of tumor-specific CD8+ T cells. Cancer Res. 2015;75:1635–44. https://doi.org/10.1158/0008-5472.CAN-14-3016.
Tohyama O, Matsui J, Kodama K, et al. Antitumor activity of lenvatinib (e7080): an angiogenesis inhibitor that targets multiple receptor tyrosine kinases in preclinical human thyroid cancer models. J Thyroid Res. 2014;2014:638747.
Mukherji D, Jabbour MN, Saroufim M, Temraz S, Nasr R, Charafeddine M, Assi R, Shamseddine A, Tawil AN. Programmed death-ligand 1 expression in muscle-invasive bladder cancer cystectomy specimens and lymph node metastasis: a reliable treatment selection biomarker? Clin Genitourin Cancer. 2016;14:183–7. https://doi.org/10.1016/j.clgc.2015.12.002.
Patel SP, Kurzrock R. PD-L1 expression as a predictive biomarker in cancer immunotherapy. Mol Cancer Ther. 2015;14:847–56. https://doi.org/10.1158/1535-7163.MCT-14-0983.
Makker V, et al. A multicenter, open-label, randomized, phases III study to compare the efficacy and safety of lenvatinib in combination with pembrolizumab versus treatment of physician’s choice in patients with advanced endometrial cancer. Gynecol Oncol. 2021;162:S4.
Eskander RN, et al. Pembrolizumab plus chemotherapy in advanced endometrial cancer. New Engl J Med. 2023. https://doi.org/10.1056/NEJMoa2302312.
ClinicalTrials.gov. Pembrolizumab (MK-3475) Plus Lenvatinib (E7080/MK-7902) versus chemotherapy for endometrial carcinoma (ENGOT-en9 MK-7902-001). https://clinicaltrials.gov/ct2/show/NCT04865289. Accessed 16 June 2021. China Extension Study (LEAP-001). ClinicalTrials.gov Identifier: NCT04865289.
ClinicalTrials.gov. Testing the addition of the immunotherapy drug, Pembrolizumab, to the usual radiation treatment for newly diagnosed early stage high intermediate risk endometrial cancer. https://clinicaltrials.gov/ct2/show/NCT04214067. Accessed 16 June 2021. ClinicalTrials.gov Identifier: NCT04214067.
Marth C, Tarnawski R, Tyulyandina A, et al. Phase 3, randomized, open-label study of pembrolizumab plus lenvatinib versus chemotherapy for first-line treatment of advanced or recurrent endometrial cancer: ENGOT-en9/LEAP-001. Int J Gynecolog Cancer. 2022;32:93–100.
Schwark AL, Srinivasan P, Kemel Y, et al. Pan-cancer microsatellite instability to predict for presence of Lynch syndrome. 2018 ASCO Annual Meeting. Abstract LBA1509. Presented 4 June 2018.
Goodfellow PJ, Billingsley CC, Lankes HA, et al. Combined microsatellite instability, MLH1 methylation analysis, and immunohistochemistry for lynch syndrome screening in endometrial cancers from GOG210: an NRG oncology and gynecologic oncology group study. J Clin Oncol. 2015;33:4301–8.
Ferguson SE, Aronson M, Pollett A, et al. Performance characteristics of screening strategies for Lynch syndrome in unselected women with newly diagnosed endometrial cancer who have undergone universal germline mutation testing. Cancer. 2014;120:3932–9.
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Mahajan, D.S., Kalnawat, N.R., Paliwal, V. et al. Immunotherapy in Chemorefractory Endometrial Cancer: Ray of Hope?. Indian J Gynecol Oncolog 21, 59 (2023). https://doi.org/10.1007/s40944-023-00733-5
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DOI: https://doi.org/10.1007/s40944-023-00733-5