Drug updated on 10/25/2024
Dosage Form | Injection (intravenous; 500 mg/10 mL [50 mg/mL]) |
Drug Class | Programmed death receptor-1 (PD-1) blocking antibodies |
Ongoing and Completed Studies | ClinicalTrials.gov |
Indication
- Indicated for the treatment of adult patients with primary advanced or recurrent endometrial cancer (EC), in combination with carboplatin and paclitaxel, followed by JEMPERLI
- as a single agent
- Indicated as a single agent for the treatment of adult patients with mismatch repair deficient (dMMR) recurrent or advanced EC, as determined by an FDAapproved test, that has progressed on or following prior treatment with a platinum-containing regimen in any setting and are not candidates for curative surgery or radiation
- Indicated as a single agent for the treatment of adult patients with dMMR recurrent or advanced solid tumors, as determined by an FDA-approved test, that have progressed on or following prior treatment and who have no satisfactory alternative treatment options.
Latest News
Summary
- This summary is based on the review of four systematic review(s)/meta-analysis(es). [1-4]
- The addition of immune checkpoint inhibitors (ICIs) to chemotherapy significantly improved progression-free survival (PFS (OS)) in advanced endometrial cancer patients, with a pooled hazard ratio (HR) of 0.63 (95% CI (Confidence interval), 0.52-0.76) in the overall population, and a greater benefit in deficient DNA (ctDNA) mismatch repair (dMMR) patients (pooled HR, 0.34; 95% CI, 0.27-0.44).
- For proficient DNA mismatch repair (pMMR) patients, PFS improvement was significant only when anti-PD1 (pembrolizumab, nivolumab, dostarlimab) agents were used (HR 0.64; 95% CI, 0.46-0.90), while anti-PD-L1 (avelumab, atezolizumab, durvalumab) agents did not show a statistically significant benefit (HR 0.87; 95% CI, 0.73-1.03).
- Overall response rates (ORR) for single-agent anti-PD1 and anti-PD-L1 therapies ranged from 26.7% to 58% in microsatellite instability (MSI) patients and from 3% to 26.7% in microsatellite stable (MSS) patients, with combinations of ICIs and tyrosine kinase inhibitors (TKIs) showing ORRs of 32% to 63.6% in all-comers.
- Treatment-related adverse events (TRAEs) were reported in 54.2% to 76% of patients, with the combination of immune checkpoint inhibitors (ICIs) and tyrosine-kinase inhibitors (TKIs) showing a higher toxicity rate, with grade ≥3 TRAEs reaching 88.9%.
- Single-agent ICIs, such as pembrolizumab, nivolumab, and dostarlimab, had a lower incidence of severe TRAEs compared to combination therapies with TKIs, which demonstrated a higher overall toxicity profile.
- In advanced endometrial cancer, patients with deficient DNA mismatch repair (dMMR) benefit significantly from both anti-PD1 and anti-PD-L1 agents, while proficient DNA mismatch repair (pMMR) patients only show a significant benefit when treated with anti-PD1 agents. Microsatellite instability (MSI) patients have higher overall response rates (ORRs) and disease control rates (DCRs) with single-agent immune checkpoint inhibitors (ICIs) compared to microsatellite stable (MSS) patients, with MSS patients showing greater benefit from the combination of ICIs with tyrosine kinase inhibitors (TKIs).
Product Monograph / Prescribing Information
Document Title | Year | Source |
---|---|---|
Jemperli (dostarlimab-gxly) Prescribing Information. | 2024 | GlaxoSmithKline LLC., Philadelphia, PA |
Systematic Reviews / Meta-Analyses
Clinical Practice Guidelines
Document Title | Year | Source |
---|---|---|
The Polish Society of Gynecological Oncology Guidelines for the Diagnosis and Treatment of Endometrial Carcinoma (2023) | 2023 | Journal of Clinical Medicine |
Biomarkers for Systemic Therapy in Metastatic Breast Cancer: ASCO Guideline Update | 2022 | Journal of Clinical Oncology |
Endometrial cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up. | 2022 | Annals of Oncology |