Unmet Needs in Patients With Recurrent and dMMR Endometrial Cancer

A retrospective study analyzed treatment patterns and outcomes for patients with advanced endometrial cancer. While mismatch repair (MMR) and microsatellite instability (MSI) testing has become standard, its use in guiding treatment decisions varies. Patients with MMR-deficient (dMMR) tumors had longer treatment-free periods compared to those with MMR-proficient (pMMR). However, the use of newer, targeted therapies based on MMR/MSI status is still suboptimal. This suggests a need for improved education and access to these treatments, especially for underrepresented populations.

Here, Bhavana Pothuri, MD, gynecologic oncologist at NYU Langone Health, discusses the unmet needs in these patient populations.

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0:05 | The unmet needs in endometrial cancer are in the recurrent setting and in the mismatch repair-proficient frontline setting. In the [mismatch repair-deficient (dMMR)] cohort of patients, we have immunotherapy in addition to chemotherapy, which has hazard ratios of 0.28 to 0.3. I think some of these therapies are curative. It has been remarkable. But I think the mismatch repair-proficient subgroup still had benefit, and that hazard ratio was 0.54. There is still room to improve in that subset of patients. Anything we can do to either add to the immunotherapy or beat those results would be beneficial in the frontline and in the recurrent setting.

1:19 | Now that immunotherapy is becoming more utilized in the frontline setting, we do not really have any data in patients after the use of immunotherapy, so that becomes a critical and unmet critical unmet need for our patients. I was reflecting recently as I was seeing patients in clinic, and I have several patients who have stage IV endometrial cancer who are now alive 4 to 5 years later and are in need of subsequent lines of therapy. Fortunately, my patients were able to capitalize on incredible clinical trial opportunities. But that goes to show you that we need additional therapies for this disease. I think the more therapies we have post-[immuno-oncology (IO)] progression, the more impactful it will be, and I think you are going to see benefit for these patients. I have been seeing it in a clinical trial setting already.