Long-term outcomes of immunotargeted therapy in the treatment of advanced endometrial cancer

Background. Endometrial cancer (EC) is a significant global health problem. Treatment outcomes for recurrent EC have long been unsatisfactory: with standard platinum-based combination chemotherapy, the 5-year survival rate for these patients does not exceed 18 %. EC treatment is currently undergoing significant transformation, primarily due to the advent of molecular classification. Immunotherapy research has led to the development of a highly effective therapeutic option (pembrolizumab with lenvatinib) for advanced microsatellite-stable / MMR-proficient (MMS / pMMR) EC, necessitating the evaluation of long-term outcomes and parameters affecting its efficacy.

Aim. To evaluate the long-term outcomes of immunotargeted therapy (ITT) for advanced MMS / pMMR EC and to identify clinical and morphological parameters affecting its efficacy.

Materials and methods. The study analyzed data from 60 patients with advanced MMS / pMMR EC received ITT in oncological dispensaries in Siberia and the Russian Far East. Progression-free survival (PFS) was analyzed using the Kaplan–Meier method, with PFS defined as the time from the ITT initiation until disease progression or death against the background of treatment. The influence of the selected clinical and morphological parameters on PFS was assessed using the log-rank test. Differences in patient subgroups divided by median PFS were assessed using the Mann–Whitney test for independent samples (quantitative variables) and Fisher’s exact test (qualitative variables). Differences were considered statistically significant when the significance level was reached (p <0.05)

Results. The median PFS in patients with advanced EC who received ITT was 12.6 months, with the lower quartile was

5 months and the upper quartile was 28.1 months. Among patients who had disease progression before 12.6 months, 25 % had progression within 2.57 months, and 75 % had progression within 6 months. The median time to progression was 4.05 months. Among patients who survived 12.6 months without disease progression, only the 75 % quartile, which was 16 months, was identified. The median PFS was not reached. Clinical and morphological parameters influencing the efficacy of ITT were identified.

Conclusion. ITT is currently a promising option for long-term control of advanced EC after platinum-based chemotherapy.

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