ESMO Asia 2025 | Treatment strategies for non-dMMR advanced metastatic endometrial cancer
Ka Yu Tse, MBBS, The University of Hong Kong, Hong Kong, China, discusses the current treatment landscape for advanced metastatic endometrial cancer, highlighting the role of immunotherapy and chemotherapy. Immunotherapy has shown to have limited benefits in patients with non-deficient mismatch repair (non-DMMR) or proficient mismatch repair (pMMR) profiles, and it can be combined with other agents, such as tyrosine kinase inhibitors (TKI) or bevacizumab. This interview took place at 2025 European Society for Medical Oncology (ESMO) Asia Congress in Singapore, Singapore.
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Transcript
Thank you very much. And so nowadays for advanced metastatic endometrial cancer, most of them will be treated by the backbone will be chemotherapy. And then nowadays we also have immunotherapy, which plays a very important role in this scenario as well. But then for MMRd patients, that means non-DMMR patients, actually their response rates or other benefits from the immunotherapy actually is not as prominent or not promising as patients with DMMR...
Thank you very much. And so nowadays for advanced metastatic endometrial cancer, most of them will be treated by the backbone will be chemotherapy. And then nowadays we also have immunotherapy, which plays a very important role in this scenario as well. But then for MMRd patients, that means non-DMMR patients, actually their response rates or other benefits from the immunotherapy actually is not as prominent or not promising as patients with DMMR. So that’s why for my talk, I basically went through the immunotherapy profiles or the response and also the performance in patients with MMRd patients, also known as non-dMMR or pMMR. And then I also touched on like adding some other agents like TKI or bevacizumab or PARP inhibitor in combinations with immunotherapy in this setting. And then at the end, I also gave some examples of what other novel agents that could be considered. So for previous experience with bevacizumab or TKI, or basically mainly bevacizumab, together with chemotherapy, in fact, some meta-analysis shows that the benefit was not very good, unlike other cancer like ovarian cancer. So that’s why I think for bevacizumab, it’s not a routine in advanced metastatic endometrial cancer. And then, honestly, there are not too many studies looking specifically about chemotherapy, and also immunotherapy in advanced endometrial cancer. There’s some ongoing study, but the results were not available yet. And we also had one study called LIB001, which looked at pembrolizumab together with lenvatinib. They tried to see whether this combination can replace chemotherapy at frontline setting. However, this one was a negative study, which shows that the benefits in the overall ITT intention to treat population, actually, we couldn’t see a benefit as such. And then obviously, the benefits in pMMR patients was not promising at all. There’s some benefits apparently in dMMR patients, but then because of the design of the study, we still could not use these results, sort of like evidence to replace chemotherapy.
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