Exercise no. 316 Dostarlimab (Jemperli°) in advanced or recurrent endometrial cancer with DNA repair defects

First-line treatment for patients with advanced endometrial cancer (i.e. that has spread beyond the endometrium, with or without regional lymph node involvement) is generally based on surgery, radiotherapy and platinum-containing chemotherapy. If the disease is refractory to treatment or relapses, and chemotherapy is being considered, one option is the combination of lenvatinib (an inhibitor of various tyrosine kinases including those associated with VEGF receptors) + pembrolizumab (an immunostimulatory anti-PD-1 antibody). In a randomised trial that compared this combination to monotherapy with a cytotoxic drug, lenvatinib + pembrolizumab extended median survival by 7 months, but led to more treatment discontinuations due to adverse effects (reported in 33% of patients versus 8% with the cytotoxic drug).