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Pembrolizumab May Improve Disease-Free Survival in Patients With High-Risk Endometrial Cancer
Adding pembrolizumab to adjuvant chemotherapy improved disease-free survival (DFS) in certain women with high-risk endometrial cancer, particularly those with mismatch repair-deficient tumors, according to findings from a KEYNOTE-B-21 study presented at the European Society for Medical Oncology (ESMO) Congress.
Previous research has shown that adding the anti-PD-1 antibody pembrolizumab to chemotherapy has benefits for women with advanced or recurrent endometrial cancer, regardless of mismatch repair (MMR) status. The KEYNOTE-B-21 study aimed to determine the effectiveness of pembrolizumab in combination with adjuvant chemotherapy for women with newly diagnosed, high-risk endometrial cancer who had undergone surgery.
The trial included 1095 women with newly diagnosed, histologically confirmed high-risk endometrial cancer who were disease-free after surgery. Women who had received prior radiation or systemic therapy were excluded from the trial. Researchers assigned 545 women to receive pembrolizumab with carboplatin-paclitaxel, while 550 women received a placebo with the same chemotherapy. The primary endpoints were disease-free survival and overall survival in the intention-to-treat population.
At the time of interim analysis, there were 119 DFS events in the pembrolizumab group and 121 in the placebo group. Two-year DFS rates were similar between the two groups in the overall population. However, women with MMR-deficient tumors showed significantly improved DFS with pembrolizumab compared to those with MMR-proficient tumors.
“A higher percentage of women assigned pembrolizumab experienced grade 3 or higher adverse events (71% vs. 63%). No treatment-related grade 5 events occurred,” concluded researchers.
Reference
Shinkle, Matthew. Benefit of adjuvant pembrolizumab in endometrial cancer varies by mismatch repair status. Healio. Published September 16, 2024. Accessed September 17, 2024. https://www.healio.com/news/hematology-oncology/20240916/benefit-of-adjuvant-pembrolizumab-in-endometrial-cancer-varies-by-mismatch-repair-status
