Adding Pembrolizumab to Chemo Improves Survival in Endometrial Cancer

TUESDAY, April 4, 2023 (HealthDay News) -- The addition of pembrolizumab to paclitaxel plus carboplatin is associated with longer progression-free survival for patients with advanced or recurrent endometrial cancer, according to a study published online March 27 in the New England Journal of Medicine.

Ramez N. Eskander, M.D., from the University of California at San Diego, and colleagues conducted a phase 3 trial involving 816 patients with measurable disease (stage III or IVA) or stage IVB or recurrent endometrial cancer to receive pembrolizumab or placebo (1:1 ratio) in addition to combination therapy with paclitaxel plus carboplatin in six cycles every three weeks followed by up to 14 maintenance cycles every six weeks. Patients were stratified according to mismatch repair-deficient (dMMR) or mismatch repair-proficient (pMMR) disease.

The researchers found that in the 12-month analysis, estimates of progression-free survival were 74 and 38 percent in the pembrolizumab and placebo groups, respectively, in the dMMR cohort (hazard ratio for progression or death, 0.30). Median progression-free survival was 13.1 and 8.7 months with pembrolizumab and placebo, respectively, in the pMMR cohort (hazard ratio, 0.54). For pembrolizumab and combination chemotherapy, adverse events were as expected.

"Pembrolizumab in combination with chemotherapy and continued as maintenance therapy led to significantly longer progression-free survival than placebo in patients with dMMR and pMMR endometrial cancers," the authors write.

Several authors disclosed financial ties to pharmaceutical companies, including Merck, the manufacturer of pembrolizumab.

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