At ASCO 2022 important abstracts were presented. The programmed death1 (PD1) inhibitor dostarlimab was investigated in the phase III GARNET study in advanced or metastatic endometrial cancer after failure of previous platinum-based combination chemotherapy. In the first group of patients with tumors with dMMR (mismatch repair-deficiency) or MSI-H (microsatellite-high; group A), the median progression-free survival (PFS) was significantly higher than in the group with pMMR (mismatch repair-proficiency) or those with MSS (microsatellite-stable) tumors (group B), i.e., 6.0 months in group A and 2.7 months in group B. Overall survival was > 50 months and 17 months, respectively. Immunotherapy-related adverse events were seen in 23% of patients, including grade 3 or 4 events in 8% of women. In all, 9% of patients discontinued treatment due to adverse events. Another important regimen is the combination of lenvatinib and pembrolizumab. In a randomized study of lenvatinib + pembrolizumab versus monotherapy with doxorubicin or paclitaxel in the second-line therapy of metastatic endometrial cancer, the chemotherapy-free regimen was superior. PFS2 was significantly higher in patients in the pMMR group and the all comer group if they received lenvatinib and pembrolizumab, compared to those receiving standard chemotherapy (p < 0.0001). In conclusion, checkpoint inhibitors +/- lenvatinib are now established in the second-line treatment of advanced endometrial cancer. Overall, the inclusion of PD1 or PDL1 inhibitors in systemic treatment regimens offers a significant opportunity for patients whose treatment options in the past only included conventional chemotherapy, radiotherapy or hormonal therapy.
