Baylor University Medical Center: Baylor University Medical Center at Dallas, Texas.
Division of Gynecologic Oncology, Department of Obstetrics & Gynecology, University of California, Irvine, California, USA.
Curr Opin Obstet Gynecol. 2023 Feb 1;35(1):34-42. doi: 10.1097/GCO.0000000000000839. Epub 2022 Dec 6.
Despite the recent upward trends in incidence and mortality of endometrial cancer, there are still limited FDA-approved therapies for patients with primary advanced and recurrent endometrial cancer. This disparity presents the opportunity for further investigation of targeted therapies in this patient population.
One such area of adjuvant therapy is immunotherapy, which has shown improved progression-free survival in patients with several solid tumors, including endometrial, leading to the FDA approval of two immune checkpoint inhibitors. Additionally, with further study of precision medicine, the current adjuvant treatment paradigms that exist based on histopathologic subtype alone may be shifting towards a new genomic-based approach.
This article is a snapshot of the origins of immunotherapy use in this patient population as well as a guide to its future use. The author's hope with this article is to describe the patient population as well as the history of the integration of immunotherapy use into the adjuvant treatment of endometrial cancer leading up to FDA approval of Pembrolizumab and Dostarlimab. This article also consolidates the current literature as well as ongoing clinical trials that will hopefully lead to FDA approval of more immunotherapeutic agents in the near future.
尽管子宫内膜癌的发病率和死亡率最近呈上升趋势，但对于原发性晚期和复发性子宫内膜癌患者，仍仅有有限的 FDA 批准的治疗方法。这种差异为该患者群体的靶向治疗提供了进一步研究的机会。
辅助治疗的一个领域是免疫疗法，它已显示在包括子宫内膜癌在内的几种实体瘤患者中改善了无进展生存期，这导致了两种免疫检查点抑制剂的 FDA 批准。此外，随着对精准医学的进一步研究，目前基于单一组织病理学亚型的辅助治疗模式可能正在向新的基于基因组的方法转变。
本文概述了免疫疗法在这一患者群体中的应用起源，以及其未来的应用前景。作者希望通过本文描述患者人群以及免疫疗法在子宫内膜癌辅助治疗中的应用历史，直至 Pembrolizumab 和 Dostarlimab 获得 FDA 批准。本文还整合了目前的文献和正在进行的临床试验，希望在不久的将来能有更多的免疫治疗药物获得 FDA 批准。
