Management of metastatic endometrial cancer: physicians’ choices beyond the first line after approval of checkpoint inhibitors

Frontiers in Oncology

Oncology

Claudio Zamagni¹  Domenica Lorusso²  Massimo Di Maio³  Giorgio Valabrega³  Valentina Tuninetti³  Graziana Ronzino⁴  Antonella Savarese⁵  Giulia Scotto⁶  Margherita Turinetto⁶  Gaia Giannone⁷  Carmela Pisano⁸  Sandro Pignata⁸  Vanda Salutari⁹  Francesca Arezzo^1,10  Gennaro Cormio^1,11  Vera Loizzi^1,11  Giorgia Mangili^1,12  Grazia Artioli^1,13  Serafina Mammoliti^1,14  Daniele Castaldo^1,15  Michele Bartoletti^1,16 

[1] Azienda Ospedaliero-universitaria di Bologna, IRCCS, Bologna, Italy;Department of Life Science and Public Health, Catholic University of Sacred Heart Largo Agostino Gemelli, and Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy;Department of Oncology, Mauriziano Hospital, University of Turin, Turin, Italy;Department of Oncology, Ospedale “Vito Fazzi”, Lecce, Italy;Department of Oncology, Regina Elena National Cancer Institute, Rome, Italy;Department of Oncology, University of Turin, Turin, Italy;Department of Surgery and Cancer, Imperial College London, London, United Kingdom;Department of Urology and Gynecology, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale Napoli, Naples, Italy;Department of Women and Child Health, Division of Gynecologic Oncology, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy;Gynecologic Oncology Unit, IRCCS Istituto Tumori “Giovanni Paolo II”, Bari, Italy;Department of Precision and Regenerative Medicine – Ionian Area, University of Bari “Aldo Moro”, Bari, Italy;Gynecologic Oncology Unit, IRCCS Istituto Tumori “Giovanni Paolo II”, Bari, Italy;Interdisciplinar Department of Medicine, University of Bari “Aldo Moro”, Bari, Italy;Obstet-Gynecol Department, San Raffaele Scientific Institute, IRCCS, Milan, Italy;Oncologia Medica, Unità locale socio sanitaria n2 (ULSS2) Marca Trevigiana, Treviso, Italy;Ospedale Policlinico San Martino - Department of Medical Oncology, IRCCS, Genoa, Italy;Segreteria Multicenter Italian Trials in Ovarian Cancer and Gynecologic Malignancies (MITO) Group, Naples, Italy;Unit of Medical Oncology and Cancer Prevention, Department of Medical Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy;

关键词: endometrial cancer;    molecular classification;    immune checkpoint inhibitors;    dostarlimab;    pembrolizumab plus lenvatinib;   

DOI  :  10.3389/fonc.2023.1247291

 received in 2023-06-25, accepted in 2023-08-28,  发布年份 2023

来源: Frontiers

【 摘 要 】

IntroductionEndometrial cancer (EC) represents 3.4% of all newly diagnosed cancer cases and is responsible for 2.1% of all cancer-related deaths. Approximately 10%–15% of women with EC are diagnosed with advanced-stage disease, resulting in a reported 5-year survival rate of only 17% for those with distant metastases. A better understanding of its molecular features has ushered in a new era of immunotherapy for the treatment of EC, allowing for alternative therapeutic approaches, even in cases of advanced disease.MethodsWe administered a multi-choice online survey for Multicenter Italian Trials in Ovarian cancer and gynecologic malignancies (MITO) members. The questionnaire was available for 2 months, starting in October 2022. Our objective was to evaluate the current attitude of incorporating molecular characterization of EC into routine clinical practice, appraise the implementation of newly available therapies, and compare the outcomes with the previous survey conducted in April–May 2021 to ascertain the actual changes that have transpired during this recent time period.ResultsThe availability of molecular classification in Italian centers has changed in 1 year. Seventy-five percent of centers performed the molecular classification compared with 55.6% of the previous survey. Although this percentage has increased, only 18% performed all the tests. Significant changes have occurred in the administration of new treatments in EC patients in MITO centers. In 2022, 82.1% of the centers administrated dostarlimab in recurrent or advanced MMR-deficient (dMMR) EC experiencing disease progression after platinum-based chemotherapy regimens, compared to only 24.4% in 2021. In 2022, 85.7% of the centers already administrated the pembrolizumab plus lenvatinib combination as a second-line therapy for MMR-proficient (pMMR) patients with advanced or recurrent EC who had progressed from first-line platinum-based therapy.ConclusionBoth the therapeutic and diagnostic scenarios have changed over the last couple of years in MITO centers, with an increased prescription of immune checkpoint inhibitors and use of the molecular classification.

【 授权许可】

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Copyright © 2023 Arezzo, Giannone, Castaldo, Scotto, Tuninetti, Turinetto, Bartoletti, Mammoliti, Artioli, Mangili, Salutari, Lorusso, Cormio, Loizzi, Zamagni, Savarese, Di Maio, Ronzino, Pisano, Pignata and Valabrega