David M. O’Malley, MD, spoke about the approval of pembrolizumab for patients with advanced endometrial carcinoma that is microsatellite instability-high or mismatch repair deficient.
David M. O’Malley, MD, director of the Division of Gynecologic Oncology at the Ohio State University Comprehensive Cancer Center-The James and professor in the Department of Obstetrics and Gynecology at The Ohio State University College of Medicine, spoke with CancerNetwork® about the recent approval of pembrolizumab (Keytruda) for patients with advanced endometrial carcinoma that is microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR).1
The phase 2 KEYNOTE-158 trial (NCT02628067), for which O’Malley was the lead investigator, led to the approval of this treatment. In total, 90 patients received pembrolizumab at 200 mg intravenously every 3 weeks until unacceptable toxicity or disease progression.2 Patients had an objective response rate of 48% (95% CI, 37%- 60%), and the duration of response was not reached.
What [is important for] these patients is an option beyond chemotherapy. In the past, the chemotherapy [options] after carboplatin and paclitaxel was quite limited in its response rate and duration of responses of only 3 to 4 months. When we see the data with regards to the recent update and publication in the Journal of Clinical Oncology, we see response rates of 48%. If you get a response, the chance that response lasts more than or equal to 3 years is approximately two-thirds. These are durable, long-lasting responses, and we may be talking about curative intent in patients with recurrent uterine cancer that is MSI-H or dMMR deficient.