Immune checkpoint inhibitors for recurrent endometrial cancer. Issue 3 (4th March 2022)

• Record Type: Journal Article
• Authors: Mutlu, Levent; Harold, Justin; Tymon-Rosario, Joan; Santin, Alessandro D.
• Is Part Of: Expert review of anticancer therapy. Volume 22:Issue 3(2022)
• Page Start: 249
• Page End: 258
• Publication Date: 2022-03-04
• Subjects: Endometrial cancer -- immune checkpoint inhibitors -- immunotherapy -- PD-1 inhibitor -- PD-L1 inhibitor -- targeted therapy; Cancer -- Treatment -- Periodicals; 616.99406
• DOI: 10.1080/14737140.2022.2044311
• Languages: English
• ISSNs: 1473-7140

Abstract

ABSTRACT: Introduction: Endometrial cancer (EC) is the most common gynecologic malignancy. Outcomes for patients with advanced and/or recurrent disease have been modest with the use of chemotherapy. The approval of immune checkpoint inhibitors targeting PD-1 has recently revolutionized human cancer treatment. Recent trials with immune checkpoint inhibitors used alone or in combination with other agents, have demonstrated remarkable efficacy in the treatment of the all-comers EC patient population. Areas covered: In this article, we review major clinical trials on PD-1/PD-L1 inhibitors in advanced and recurrent EC and discuss the response rates of these agents in the context of their genomic background. Expert opinion: Immune checkpoint inhibitors have significantly changed our approach to the treatment of advanced/recurrent EC. Single agent anti-PD-1 regimens are highly effective in MMRd/MSI-H patients, but their clinical efficacy remains modest in MMR proficient/TMB low EC patients. Combination regimens that can decrease the tumor microenvironments immunosuppression and increase tumor immunogenicity represent a viable treatment option to broaden the activity of immune checkpoint inhibitors in advanced/recurrent EC patients. An increased understanding of the biomarkers of response and the molecular mechanisms of resistance to immune checkpoint inhibitors remains key for the next advancement of the field.