Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of California Los Angeles, Los Angeles, California, USA.
Curr Opin Obstet Gynecol. 2024 Feb 1;36(1):1-8. doi: 10.1097/GCO.0000000000000917. Epub 2023 Sep 28.
The scope of immuno-oncology in endometrial cancer has changed rapidly in the last several years, requiring up-to-date knowledge for those who treat these patients.
This article will focus on molecular profiling, recent trials, and FDA approvals of targeted immuno-oncology medications in endometrial cancer. These include immune checkpoint inhibitors alone or with combination treatment.
The publication of the TCGA has led to significant focus on molecular subgroupings into POLEm, MMRd, NSMP, and p53m groups. For those patients with MMRd vs. MMRp tumors, there are indications for single agent immune checkpoint inhibitors with dostarlimab or pembrolizumab. For those with MMRp tumors, the addition of lenvatinib to pembrolizumab has proven clinical benefit. The recent publication of the RUBY and NRG-GY018 trials have shown clinical benefit in both subgroups with addition of immune checkpoint inhibitor to platinum-based chemotherapy. Now there is approval for use of dostarlimab in frontline chemotherapy and maintenance for advanced stage or recurrent endometrial cancer. Several upcoming trials investigating molecular subgroups from the TCGA are eagerly anticipated.
近年来，免疫肿瘤学在子宫内膜癌中的应用范围迅速扩大，这就要求治疗这些患者的医生掌握最新的知识。
本文将重点介绍子宫内膜癌中分子谱分析、最近的试验和 FDA 批准的靶向免疫肿瘤药物，包括单独使用免疫检查点抑制剂或联合治疗。
TCGA 的发表促使人们高度关注 POLEm、MMRd、NSMP 和 p53m 等分子亚群。对于 MMRd 与 MMRp 肿瘤患者，有指征使用单药免疫检查点抑制剂，包括 dostarlimab 或 pembrolizumab。对于 MMRp 肿瘤患者，pembrolizumab 联合 lenvatinib 已被证明具有临床获益。最近 RUBY 和 NRG-GY018 试验的发表表明，在铂类化疗中加入免疫检查点抑制剂，在这两个亚组中均具有临床获益。现在 dostarlimab 已被批准用于晚期或复发性子宫内膜癌的一线化疗和维持治疗。人们急切期待着即将进行的几项针对 TCGA 分子亚群的研究。
