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晚期或复发性子宫内膜癌的免疫治疗与化疗

Immunotherapy and Chemotherapy for Advanced or Recurrent Endometrial Carcinoma.

作者信息

Micha John P, Bohart Randy D, Gorman Joshua P, Goldstein Bram H

机构信息

Women's Cancer Research Foundation, Laguna Beach, CA, U.S.A.

Oso Home Care, Inc., Irvine, CA, U.S.A.

出版信息

Anticancer Res. 2025 Jul;45(7):2711-2717. doi: 10.21873/anticanres.17641.

Abstract

Patients with early-stage endometrial cancer are frequently treated with surgery and radiotherapy or chemotherapy, for which 5-year survival rates approach 95%; conversely, the outcomes for patients with advanced or recurrent endometrial cancer are more inauspicious. Fortunately, the advent of immunotherapy, combined with chemotherapy, has conferred improved survival, especially in endometrial cancer patients with a mismatch repair deficiency (dMMR). We conducted an extensive PubMed search on the topics of endometrial cancer and immunotherapy treatment. The combination of dostarlimab and chemotherapy reportedly coincides with a 2-year progression-free survival (PFS) of 61% compared to a 12-month PFS of 74% for pembrolizumab. Moreover, the follow-up data for dostarlimab extended beyond 44 months and the median overall survival (OS) has not been reached compared to more limited OS data for both pembrolizumab and durvalumab; additionally, dostarlimab's pronounced risk of disease progression or death in both dMMR (70%) and mismatch repair-proficient (pMMR) (46%) patients is considerable. While pembrolizumab, dostarlimab and durvalumab with chemotherapy are associated with beneficial outcomes in advanced-stage or recurrent endometrial cancer, dostarlimab has distinguished itself with unsurpassed survival data compared to pembrolizumab and durvalumab.

摘要

早期子宫内膜癌患者通常接受手术及放疗或化疗,其5年生存率接近95%;相反,晚期或复发性子宫内膜癌患者的预后则更为不佳。幸运的是,免疫疗法与化疗联合应用提高了生存率,尤其是在错配修复缺陷(dMMR)的子宫内膜癌患者中。我们在PubMed上对子宫内膜癌和免疫疗法治疗的主题进行了广泛检索。据报道,多斯塔利单抗与化疗联合应用时,2年无进展生存期(PFS)为61%,而帕博利珠单抗的12个月PFS为74%。此外,多斯塔利单抗的随访数据超过44个月,与帕博利珠单抗和度伐利尤单抗更有限的总生存期(OS)数据相比,其OS中位数尚未达到;此外,多斯塔利单抗在dMMR(70%)和错配修复 proficient(pMMR)(46%)患者中疾病进展或死亡的显著风险相当大。虽然帕博利珠单抗、多斯塔利单抗和度伐利尤单抗与化疗联合应用在晚期或复发性子宫内膜癌中都有有益的结果,但与帕博利珠单抗和度伐利尤单抗相比,多斯塔利单抗以无与伦比的生存数据脱颖而出。

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