Precision in Endometrial Cancer: Personalized Treatment Strategies for pMMR and dMMR Endometrial Cancer-Charting the Course: Treatment Approaches for pMMR Endometrial Cancer

Charting the Course: Treatment Approaches for pMMR Endometrial Cancer

Video Transcription

Video Summary

The symposium focused on treatment strategies for mismatch repair-deficient (DMMR) endometrial cancer, where immunotherapy has transformed care. Dr. Ramesh Eskandar reviewed the rising global burden of endometrial cancer and explained how DMMR predicts strong responses to immune checkpoint inhibitors because of increased tumor mutational burden. He highlighted phase III trials showing that adding checkpoint inhibitors to chemotherapy, followed by maintenance immunotherapy, significantly improves response rates and survival, leading to FDA approvals. However, about 30% of patients still progress early, suggesting resistance mechanisms such as tumor heterogeneity, low TMB, or aneuploidy. He also discussed adjuvant and recurrent disease studies, ongoing trials comparing chemotherapy versus single-agent immunotherapy, and questions about whether chemotherapy is still needed in DMMR disease. Finally, he reviewed emerging evidence that some patients may benefit from immunotherapy rechallenge, though more data are needed to define who benefits most.

Keywords

mismatch repair-deficient endometrial cancer

immunotherapy

immune checkpoint inhibitors

chemotherapy

tumor mutational burden