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656 Adding immunotherapy to first-line treatment of advanced and metastatic endometrial cancer: a meta-analysis of randomized controlled trials
  1. Giorgio Bogani1,
  2. Bradley J Monk2,
  3. Maria-Pilar Barretina-Ginesta3,
  4. Francesco Raspagliesi4,
  5. Nicoletta Colombo5,
  6. Brian Slomovitz6 and
  7. Mansoor Raza Mirza7
  1. 1IRCCS National Cancer Institute, Milano, Italy
  2. 2Catalan Institute of Oncology, Phoenix, United States
  3. 3Mount Sinai Medical Center, Barcelona, Spain
  4. 4and the Department of Obstetrics and Gynecology, Milan, Italy
  5. 5Florida International University, Milan, Italy
  6. 6Department of Gynecologic Oncology, Miami Beach, United States
  7. 7Rigshospitalet – Copenhagen University Hospital, Copenhagen, Denmark


Introduction/Background Immunotherapy represents a paradigm shift in endometrial cancer treatments, especially in those with mismatch repair deficient profiles (MMRd/MSI-H). Accumulating evidence supported the adoption of immunotherapy in combination with chemotherapy in a first line setting. Recently, the results of the ongoing RUBY (part 1), NRG-GY018, AtTEnd, and DUO-E trials were released. Here, we aim to reported pooled data of those four studies.

Methodology This is a meta-analysis of phase III trials (RUBY (part 1), NRG-GY018, AtTEnd, and DUO-E) evaluating the role of immunotherapy in first-line setting for advanced/recurrent endometrial cancer

Results The pooled data of 2,320 patients included in those trials supported the adoption of chemotherapy plus immunotherapy, being related to significant improvement in progression-free survival in comparison to chemotherapy alone (HR: 0.70 (95%CI: 0.62, 0.79)) in all comers. The progression-free survival is more pronounced in the MMRd/MSI-H tumor (n=563; HR: 0.33 (95%CI: 0.23, 0.43)). This benefit, even less robust, is present also in the MMRp/MSS group (n=1,757; HR: 0.74 (95%CI: 0.60, 0.91)). Pooled data showed that chemotherapy plus immunotherapy improves overall survival in comparison to chemotherapy alone, in all comers (HR: 0.75 (95%CI: 0.63, 0.89)). However, the maturity rates of survival data are low.

Conclusion Exploratory analyses are ongoing to identify non-responding patients who deserve to be included in clinical trials and responding patients who deserve to be treated with chemotherapy-free regimens. In this latter setting, de-escalation would be proposed to improve quality of life, without neglecting long-term oncologic outcomes.

Disclosures None.

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