Overview of Current Treatment Landscape of Advanced Endometrial Cancer

Summary for Physicians: Current Treatment Landscape of Advanced EC

The treatment landscape for advanced EC has evolved significantly, incorporating both traditional therapies and newer immunotherapeutic approaches.

1. First-Line Treatment:

• For advanced or recurrent EC, platinum-based chemotherapy (eg, carboplatin and paclitaxel) remains the standard first-line treatment. This approach is commonly used for patients with nonmismatch repair deficient (non-dMMR) tumors.

1. Role of Immunotherapy:

• ICIs, such as pembrolizumab and nivolumab, have emerged as a promising treatment for patients with dMMR or microsatellite instability-high (MSI-H) tumors. These agents offer significant benefits, especially in the recurrent or metastatic setting.

• The combination of pembrolizumab with lenvatinib, an antiangiogenic agent, has demonstrated efficacy in dMMR and MSI-H EC, especially in cases that have failed prior chemotherapy.

1. Challenges and Considerations:

• Identifying patients who will benefit most from immunotherapy is a key challenge. Biomarker testing, such as mismatch repair status and MSI, plays a crucial role in predicting response to immunotherapies.

• While immunotherapies offer new opportunities, adverse effect management and the optimal sequencing of therapies are ongoing challenges.

In summary, the integration of immunotherapy into the treatment of advanced EC, particularly for dMMR or MSI-H tumors, marks a significant shift in therapeutic options, alongside the continued role of chemotherapy. Ongoing research and biomarker-driven approaches are crucial to optimizing outcomes for patients with advanced EC.