Immunotherapy
For Uterine Cancer

How is Immunotherapy for Uterine Cancer Changing the Outlook for Patients?

Reviewed by:

Dmitriy Zamarin, MD, PhD
Memorial Sloan Kettering Cancer Center

Immunotherapy for uterine (endometrial) cancer is an emerging area of research and treatment, especially for patients with advanced cases.

Uterine cancer, also known as endometrial cancer, occurs when cells that line the inside of the uterus start to grow uncontrollably. Cancer can develop in the upper part (uterine corpus), commonly referred to as uterine cancer, or the lower part (uterine cervix), commonly referred to as cervical cancer.

Common risk factors associated with uterine cancer include obesity, hormonal shifts in estrogen production, age, diets high in fat, diabetes, family history of certain cancers, and prior breast or ovarian cancer. The National Comprehensive Cancer Network recommends universal mismatch repair protein testing or microsatellite instability (MSI) testing of uterine cancers.

Uterine cancer is the sixth most common form of cancer in women and the fifteenth most common cancer type overall. Worldwide, approximately 382,000 new cases are diagnosed each year and there are an estimated 90,000 deaths. Of these, the United States accounts for approximately 66,000 of these new cases and 13,000 deaths. The prognosis of endometrial carcinoma is determined primarily by disease stage, grade, and histology. The five-year survival rate for individuals diagnosed with stage 1 disease is approximately 80 to 90 percent, for stage 2 it is 70 to 80 percent, and for stages 3 and 4 it is 20 to 60 percent.  

If detected early, uterine cancer is easy to treat, but new treatment options are needed for patients with advanced cases and for patients wishing to avoid surgery and keep their reproductive systems intact.

Uterine Cancer Treatment Options

Standard treatments for uterine cancer include surgery, radiation therapy, hormone therapy, targeted therapy, and chemotherapy. Immunotherapy is an emerging area of research and treatment for endometrial cancer.

Immunotherapy is class of treatments that take advantage of a person’s own immune system to help kill cancer cells. There are currently two FDA-approved immunotherapies for the treatment of uterine cancer.

Immunomodulators

• Dostarlimab (Jemperli): a checkpoint inhibitor that targets the PD-1 pathway; approved for subsets of patients with recurrent or advanced endometrial cancer with mismatch repair deficiency (dMMR)
• Pembrolizumab (Keytruda®): a checkpoint inhibitor that targets the PD-1/PD-L1 pathway; approved for subsets of patients with advanced endometrial cancer, including those with tumors with high microsatellite instability (MSI-H) or high tumor mutational burden (TMB-H); also approved in combination with lenvatinib for advanced/recurrent endometrial cancer that is DNA mismatch repair proficient (pMMR)

Other immunotherapies are also currently being tested in clinical trials, which patients of any type or stage of uterine cancer are encouraged to explore.

CRI’s Impact in Uterine Cancer

Since 1953, the Cancer Research Institute has dedicated more than $10 million in funding to develop and discover immunotherapies that can treat gynecologic cancers, including uterine cancer. Research findings from leading immunologists continue to demonstrate potential and promise for the future of immune-based treatment for patients with uterine cancer.

• In 2018, the CRI Clinical Accelerator launched a clinical trial to evaluate the effectiveness of PD-1 inhibitors plus or minus CTLA-4 inhibitors in patients with advanced solid tumors that have failed standard therapy.
• In 2018, CRI fellow Monica Olcina, PhD, revealed that mutations in the complement pathway occur at higher frequencies compared to other mutations in uterine cancer and are associated with poor survival.

You can explore CRI’s current funding for uterine cancer research in our funding directory.