Results of a global study point to a new standard of care for women with endometrial cancer, adding immunotherapy to standard chemotherapies
SCOTTSDALE, Ariz. — March 30, 2023 — HonorHealth Research Institute played a key role in what is being described as a substantial improvement in the treatment of primary advanced or first recurrent endometrial cancer, the nation’s most common gynecological malignancy.
At this week’s annual meeting of the Society of Gynecologic Oncology, a major medical conference on women’s cancer, and in a paper published Monday in The New England Journal of Medicine (NEJM), an international team of researchers found that combining an immunotherapy drug called dostarlimab with the standard chemotherapy drugs, carboplatin and paclitaxel, delayed time to recurrence with an early signal in improving survival.
These findings resulted from more than three years of research, including a recent phase 3 global clinical trial of 494 patients with either advanced or recurrent endometrial cancer. This cancer attacks the endometrium, or inner lining, of the uterus, the organ in which fetuses mature during pregnancy. Many of the women suffering from this disease participated in and were treated at HonorHealth.
Dr. Bradley J. Monk, director and principal investigator of the Gynecologic Oncology Research Group at the HonorHealth Research Institute, said the new combination of immunotherapy and chemotherapy should be presented to the FDA as the new standard of care for this cancer.
“Immunotherapy added to chemotherapy has a dramatic impact, not only in delaying the tumor from coming back but also in helping patients live longer and with better quality of life,” said Dr. Monk, one of the authors of the study published in the NEJM. He also is affiliated with both the University of Arizona and Creighton University schools of medicine.
Another prominent author of the paper is Dr. Dana Chase, who in January transferred from HonorHealth to accept a promotion as associate professor at UCLA.
Clinical trial results indicate longer survival
The clinical trial showed that patients who received immunotherapy in combination with chemotherapy had a significant improvement in progression-free survival, when compared with patients who received the chemotherapy regimen alone. The 24-month overall survival rate was 71.3% in the immunotherapy+chemotherapy arm, and 56.0% in the chemotherapy-alone arm.
Dostarlimab is among a group of immunotherapy drugs known as checkpoint inhibitors, which counter the tumor’s attempts to cloak itself from the body’s natural immune system, specifically from anti-cancer T cells. These drugs essentially stop the immune system from being turned off before all the cancer is eliminated.
The paper published in the NEJM was led by Dr. Mansoor Mirza of Copenhagen University Hospital. Among the 20 international institutions contributing to the study, the senior author was Dr. Matthew Powell of Washington University School of Medicine, St. Louis. Some of the other participants in the study included: UCLA, Mount Sinai Medical Center, and Indiana University.
The findings were bolstered by a separate study, also published Monday in the NEJM, supported by the National Cancer Institute (NCI), which used a different type of checkpoint inhibitor, pembrolizumab, which has a similar mechanism of action, and which posted similar results.
“These two studies are not competing, but complementary, bolstering the overall results,” said Dr. Monk, who is vice president of the GOG Foundation, which sponsored this study. “If there was just one study, there might be questions. But since there are two studies, this is a practicechanging opportunity that should result in FDA approval.”
More than 66,000 American women will be diagnosed this year with this type of uterine cancer, which will result in more than 13,000 deaths.
“The care and management of patients with cancer is continuously evolving. HonorHealth Research Institute’s contribution to this new, life-changing therapeutic initiative for patients with endometrial cancer is yet another example of our ability to provide patients with innovative treatments that can transform the way cancer care is delivered,” said Dr. Michael Gordon, Chief Medical Officer of the HonorHealth Research Institute.