A recent study led by PhD students Anneke Eerkens and Koen Brummel, co-supervised by Nijman and de Bruyn, has highlighted a potential breakthrough in treating endometrial cancer. The research reveals that patients with mismatch repair deficient (MMRd) endometrial cancer benefit from neo-adjuvant therapy using pembrolizumab, an immune checkpoint inhibitor.
In the study, ten patients received only two cycles of single pembrolizumab before undergoing surgery as part of their standard-of-care treatment. Remarkably, half of these patients achieved a pathologic response, with 20% of patients showing a major pathological response, with fewer than 10% tumour cells remaining. Additionally, three patients experienced partial radiological responses. Notably, all participants completed their treatment regimen without severe adverse effects, suggesting that pembrolizumab in this setting is both safe and well-tolerated.
The research group suggests that pembrolizumab could potentially replace current adjuvant therapies for patients with high-mutational endometrial cancer, such as those with MMRd. If patients show a significant response to neo-adjuvant therapy, they may avoid additional treatments like radio-(chemo)therapy, potentially improving their quality of life. A follow-up study to determine whether complete pathologic responses can be consistently achieved is now ongoing, funded by the Dutch Cancer Society. It might even become reality that surgery can be omitted, saving the potential of becoming pregnant on those with a young age.
The findings mark a significant step forward in personalized cancer treatment for endometrial cancer, offering new hope for patients facing challenging diagnoses.
Link to publication: Neoadjuvant immune checkpoint blockadein women with mismatch repair deficientendometrial cancer: a phase I study
