The Revolution of Immunotherapy in Gynecological Cancers: The Lazarus Effect in Endometrial Cancer

Patients with solid tumors and mismatch repair deficiency (dMMR) or microsatellite instability-high (MSI-H) are eligible for immunotherapy. Recently, different reports described patients with poor performance status (PS), unrelated to comorbidities, which showed a rapid improvement of their clinical...

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Bibliographic Details
Published in:Journal of clinical medicine 2023-09, Vol.12 (17), p.5540
Main Authors: Ducceschi, Monika, Polignano, Maggie, Bini, Marta, Lopez, Salvatore, Conca, Elena, Tamborini, Elena, Perrone, Federica, Carlo Stella, Giulia, Petrella, Maria Cristina, Carciotto, Rosaria, Artioli, Grazia, Maffeis, Valeria, Sartor, Lucia, Raspagliesi, Francesco, Mantiero, Mara
Format: Article
Language:English
Subjects:
Biomarkers
Cancer
Cancer therapies
Care and treatment
Case Report
Chemotherapy
Clinical medicine
Development and progression
Drug therapy
Endometrial cancer
FDA approval
Genetic counseling
Gynecological cancer
Gynecology
Hysterectomy
Immunotherapy
Lymphatic system
Medical imaging
Medical prognosis
Metastasis
Methods
Monoclonal antibodies
Narcotics
Patient outcomes
Patients
Radiation therapy
Thrombosis
Tumors
Zoledronic acid
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Summary:Patients with solid tumors and mismatch repair deficiency (dMMR) or microsatellite instability-high (MSI-H) are eligible for immunotherapy. Recently, different reports described patients with poor performance status (PS), unrelated to comorbidities, which showed a rapid improvement of their clinical conditions under immunotherapy, which evoked a Lazarus response. Very few data on the efficacy and safety of immunotherapy in patients with gynecological malignancies and poor PS are available. Based on the GARNET trial, Dostarlimab, a monoclonal antibody anti-programmed death receptor-1 (PD-1), has been approved in advanced or recurrent mismatch repair deficient endometrial cancer (EC) which progressed after platinum-based therapy. For the first time, in gynecological oncology, an immune checkpoint inhibitor drastically changed the clinical practice. We collected a multicenter case series of six patients with advanced endometrial carcinoma and PS ECOG 3–4 treated with Dostarlimab, showing exceptionally quick responses and significant improvement of PS to configure a Lazarus response.
ISSN:2077-0383
2077-0383
DOI:10.3390/jcm12175540