Immunotherapy in MMR-d/MSI-H recurrent/metastatic endometrial cancer.

IF 2.9 3区医学 Q2 ONCOLOGY Expert Review of Anticancer Therapy Pub Date : 2024-08-01 Epub Date: 2024-06-14 DOI:10.1080/14737140.2024.2367472

Renata Pacholczak-Madej, Michele Bartoletti, Lucia Musacchio, Mirosława Püsküllüoglu, Paweł Blecharz, Domenica Lorusso

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Abstract

Introduction: The advent of immunotherapy with immune checkpoint inhibitors (ICIs) has revolutionized the management of mismatch repair deficient (MMR-d)/microsatellite instability-high (MSI-H) endometrial cancer (EC). Initially investigated as monotherapy in phase I-II clinical trials for recurrent disease, immunotherapy demonstrated remarkable activity, yielding overall response rates (ORR) ranging from 27% to 58%. Based on these promising findings, phase III trials have explored the integration of immunotherapy into first-line treatment regimens for advanced/recurrent EC in combination with chemotherapy or other agents such as tyrosine kinase inhibitors (TKIs), resulting in improved ORR, progression-free survival, and overall survival compared to the standard chemotherapy regimen of paclitaxel and carboplatin. As a result, the incorporation of ICIs with standard platinum-based chemotherapy is becoming a new standard of care in MMR-d/MSI-H EC.

Areas covered: This review synthesizes literature from PubMed, Embase databases, and recent congress abstracts on gynecological cancers. It covers MMR-d/MSI-H EC incidence, molecular diagnostics, clinical trial outcomes, predictive biomarkers for ICIs, patient profiles likely to benefit, resistance mechanisms, and the future of immunotherapy in this setting.

Expert opinion: By offering a comprehensive overview, this review delineates the pivotal role of ICIs in the management of MMR-d/MSI-H EC.

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MMR-d/MSI-H 复发/转移性子宫内膜癌的免疫疗法。

导言：免疫检查点抑制剂（ICIs）免疫疗法的出现彻底改变了错配修复缺陷（MMR-d）/微卫星不稳定性高（MSI-H）子宫内膜癌（EC）的治疗方法。在针对复发性疾病的 I-II 期临床试验中，免疫疗法最初作为单一疗法进行研究，显示出显著的活性，总反应率 (ORR) 从 27% 到 58% 不等。基于这些令人鼓舞的研究结果，III 期临床试验探索了将免疫疗法纳入晚期/复发性白血病一线治疗方案，并与化疗或酪氨酸激酶抑制剂（TKIs）等其他药物联合使用，结果与紫杉醇和卡铂标准化疗方案相比，ORR、无进展生存期和总生存期均有所改善。因此，将 ICIs 与标准铂类化疗相结合正在成为 MMR-d/MSI-H EC 治疗的新标准：本综述综合了PubMed、Embase数据库和近期大会摘要中有关妇科癌症的文献。它涵盖了MMR-d/MSI-H EC的发病率、分子诊断、临床试验结果、ICIs的预测性生物标志物、可能获益的患者情况、耐药机制以及免疫疗法在这种情况下的前景：专家观点：这篇综述通过提供全面的概述，勾勒出了ICIs在MMR-d/MSI-H EC治疗中的关键作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Anticancer Therapy 医学-肿瘤学

CiteScore

5.10

自引率

3.00%

发文量

100

审稿时长

4-8 weeks

期刊介绍： Expert Review of Anticancer Therapy (ISSN 1473-7140) provides expert appraisal and commentary on the major trends in cancer care and highlights the performance of new therapeutic and diagnostic approaches. Coverage includes tumor management, novel medicines, anticancer agents and chemotherapy, biological therapy, cancer vaccines, therapeutic indications, biomarkers and diagnostics, and treatment guidelines. All articles are subject to rigorous peer-review, and the journal makes an essential contribution to decision-making in cancer care. Comprehensive coverage in each review is complemented by the unique Expert Review format and includes the following sections: Expert Opinion - a personal view of the data presented in the article, a discussion on the developments that are likely to be important in the future, and the avenues of research likely to become exciting as further studies yield more detailed results Article Highlights – an executive summary of the author’s most critical points.