A NUMBER OF ADVANCES employing combination or monotherapies have been made in the gynecologic cancer arena in 2024. Potential practice-changing therapies include, in endometrial cancer, the emergence of carboplatin, paclitaxel, and PD-1 blockade, or the use of fam-trastuzumab deruxtecan-nxki (T-DXd; Enhertu); in cervical cancer, the addition of pembrolizumab (Keytruda) to standard chemotherapy/radiotherapy; and in ovarian cancer, the combination of mirvetuximab soravtansine (Elahere) plus bevacizumab (Avastin).
Endometrial Cancer
“It’s been an exciting couple of years for endometrial cancer,” said Claire F. Friedman, MD, a gynecologic medical oncologist. New options for first-line treatment for patients with advanced or recurrent endometrial cancer include treatment with platinum chemotherapy and paclitaxel plus a PD-1 inhibitor of either dostarlimab-gxly [Jemperli] or pembrolizumab, both of which have been approved by the FDA.
The approval of dostarlimab was based on findings from the RUBY trial, showing a statistically significant overall survival improvement. Similarly, the FDA’s approval of pembrolizumab for endometrial carcinoma was based on efficacy findings from the KEYNOTE-868/NRG-GY018 trial.
Cervical Cancer
In cervical cancer, the FDA approved pembrolizumab with chemoradiotherapy for patients with FIGO 2014 stage III to IVA cervical cancer, based on findings from KEYNOTE-A18. Another option was demonstrated by findings in the INTERLACE trial, which evaluated patients with FIGO 2008 stage IB1 disease with nodal involvement or stage IB2, IIA, IIB, IIIB, or IVA disease.
Ovarian Cancer
The antibody-drug conjugate mirvetuximab soravtansine-gynx demonstrated clinical activity and a good safety profile when combined with bevacizumab in patients with recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer. Findings led to approval for the combination, based on the MIRASOL study.
The study met its primary and key secondary end points, with statistically significant results in PFS, ORR, and OS. As a result, the National Comprehensive Cancer Network listed the combination for both platinum-sensitive and platinum-resistant ovarian cancer.
These advancements represent a significant step forward in the treatment of women's cancers, offering new hope and options for patients.
