Discussing Recent Advances for Patients With Endometrial Cancer

John Nakayama, MD, gynecologic oncologist at Allegheny Health Network, discusses what the evolution of endometrial cancer treatment has looked like in recent years.

Currently, the standard treatment method for patients with endometrial cancer is the addition of immunotherapy to chemotherapy. According to Nakayama, this is standard for this patient population, regardless of disease stage.

However, recent data, some of which were highlighted at the Society of Gynecologic Oncology (SGO) Annual Meeting, may bring additional combinations to the armamentarium.

Transcription:

0:08 | Endometrial cancer has kind of been stuck since the GOG 209 study showed that carboplatin and paclitaxel were active agents and changed the standard of care. Since then, there have been marginal changes in what we've done. Then along came immunotherapy.

0:34 | Immunotherapy is kind of a broad term. What I think most people think about when we talk about that are the checkpoint inhibitors. The most recent trials are looking at targeting the PD-L1 pathway. Basically, the way I like to think of it, which is kind of simplistic, is it takes the patient’s immune system, and it turns off. What it does is it turns it up to 11 like the old amplifiers, where you turn it up to 10, as the immune system just goes all the way to 11 and just attacks. That's really what's changed recently.

1:13 | When you think about it, which population is likely to respond to that? What they've done in the past is they looked at the recurrent setting. They looked at MMR status, mismatch repair status, or MSI status, and they're kind of measuring similar things. But if you're MMR deficient or you are MSI-high, the idea is that you are more likely to respond to a checkpoint inhibitor. Now, what's happened recently is there has been the introduction of these checkpoint inhibitors in the frontline setting. Those are the trials that came out just in the last couple of weeks.