Advancing Care in Endometrial Cancer: Exploring Long-Term Outcomes and Real-World Evidence - Episode 4
Endometrial Cancer: Broadening Therapeutic Options in pMMR - Insights from DUO-E/AtTEnd
Panelists discuss how DUO-E and AtTEnd broaden options beyond PD-1 approaches, with PD-L1 and PARP–immunotherapy combinations offering promising signals for selected pMMR subgroups amid real-world access and tolerability considerations.
The DUO E and AtTEnd trials represent an important expansion of therapeutic strategies beyond PD 1 based approaches. Both evaluated PD L1 inhibitors and demonstrated meaningful clinical activity in patients with dMMR tumors, with results consistent with earlier PD 1 studies. The more complex issue is pMMR disease, where responses to chemo immunotherapy are generally less pronounced.DUO E added a PARP inhibitor to immunotherapy, creating an additional therapeutic layer. Although the PARP component did not substantially benefit dMMR tumors, it produced encouraging signals in pMMR disease, especially within molecular subgroups such as those with P53 alterations. These findings suggest that PD L1 and PARP combinations may provide expanded opportunities for selected pMMR patients, although real world use is influenced by factors such as toxicity, regulatory approval and reimbursement across regions.