Dr. Naumann on the Evolution of Immunotherapy in Endometrial Cancer

R. Wendel Naumann, MD, gynecologic oncologist, Levine Cancer Institute, Atrium Health, discusses the evolution of immunotherapy in endometrial cancer.

The landscape of endometrial cancer is changing dramatically with the integration of immunotherapy into the second-line setting for patients with endometrial cancer, Naumann says. For example, data from the pivotal Study 309/KEYNOTE-775 trial (NCT03517449) demonstrated improved progression-free survival and overall survival with the combination of pembrolizumab (Keytruda) and lenvatinib (Lenvima) vs investigator’s choice of chemotherapy in patients with advanced endometrial carcinoma that was not microsatellite instability high or mismatch repair deficient following prior systemic therapy.

It appears that lenvatinib alters the tumor microenvironment, which increases the immunogenicity of the endometrial tumors so that the immune system can attack, Naumann explains.

It is possible that immunotherapy will be moved up in the course of treatment to replace frontline chemotherapy, be combined with frontline chemotherapy, or be combined with radiation therapy, which is reserved for the adjuvant treatment of patients with intermediate- or high-risk disease who are at risk of local or distant failure, Naumann concludes.