Ritu Salani, MD, MBA: Just like in ovarian cancer, we’ve seen some exciting developments in endometrial cancer. But I want to reflect a little about where we’ve been in endometrial cancer before we dive in. One of the frustrating things about endometrial cancer is that it’s 1 of the few cancers where we’ve seen rise in incidence and mortality. What’s also alarming about uterine cancers is that we’re seeing a bigger health disparity. We see it across multiple cancers, particularly gynecological cancers, but we see it more in uterine cancers. Understanding some of these disparities will help elucidate how we can better treat these patients.

We have Bhavana here, who’s our DEI [diversity, equity, and inclusion] expert with GOG Partners. There’s been a concerted effort to better address these. Because this is an ongoing process, and we’re learning more about this, there have been some exciting developments. Since I was a fellow, carboplatin and paclitaxel has been the standard of chemotherapy, and then carboplatin-paclitaxel more recently. There have been some exciting updates, but we were complacent. I don’t mean we weren’t studying [endometrial cancer]. We just hadn’t made any progress. As we continue to look at early stage [endometrial cancer], and now we’re looking at molecular characterizations of endometrial cancer, we see some exciting developments. We’re lucky to have an expert panel [of physicians] who are leading the charge in endometrial cancer. I’d like to start with Dr Powell and talk about some of the exciting data presented at ESMO [European Society for Medical Oncology], SGO [Society of Gynecologic Oncology], and here at ASCO [American Society of Clinical Oncology].

Matthew A. Powell, MD: These are new times in endometrial cancer. Hopefully we can narrow this disparity and improve survival. The incidence rate going up is related to many factors…. Two months ago, the landscape changed in endometrial cancer. Our NCCN [National Comprehensive Cancer Network] Guidelines have changed. We’re implementing immunotherapy in the up-front treatment of patients with advanced or recurrent endometrial cancer, adding in dostarlimab or pembrolizumab for these patients. It’s been very exciting.

When we look at the trials that led to this, both were in the New England Journal of Medicine in early March. We’ll focus a little on the RUBY trial, which was an international trial with ENGOT [European Network of Gynaecological Oncological Trial groups], GOG Partners, and our other European colleagues. This was a trial that randomized carboplatin-paclitaxel plus or minus dostarlimab. It found, especially in the dMMR [mismatch repair deficient] population—patients who had defective mismatch repair or microsatellite-high tumors—a staggering hazard ratio of 0.2. We see this enormous benefit for patients, and it didn’t take long to get it published and into our guidelines. We’re actively using these regimens for patients with endometrial cancer. The exciting thing is that it also seemed to be working in our proficient population, albeit not as well. Those data are maturing, and there’s a strong signal in overall survival. Although it’s not statistically significant, it looks like it will be. We’re seeing long, flat tails on the curves for patients who seem to be benefiting a long time. [We’re even] starting to even think about curing patients with advanced and recurrent endometrial cancer.

Ritu Salani, MD, MBA: Matt, you presented the BICR [blinded independent central review] analysis for the RUBY trial, and Dr [Mansoor] Mirza presented the PROs [patient-reported outcomes]. Would you mind giving us a quick reminder of what those studies show?

Matthew A. Powell, MD: We had 2 additional abstracts at ASCO 2023 looking at the blinded independent central review for patients enrolled on RUBY. We were happy to confirm that the investigator assessments were valid and consistent across that study, as many of us hope because there could be some bias that we’re not aware of. There was good consistency there. Also, the patient-reported outcomes, which was presented well by Dr Mirza, looked at patients, how they perform, and how they do with the addition of a new drug. We could feel that there wasn’t a detriment to their quality of life and maybe some improvement. Some of [those data] are still maturing, but we’re excited to see the safety profile held up for the study and seeing this quality of life maintained.

Ritu Salani, MD, MBA: An instant game changer.

Transcript edited for clarity.