| The following article features coverage from the SGO 2022 Annual Meeting on Women’s Cancer. Click here to read more of Cancer Therapy Advisor’s conference coverage. |
Real-world data suggest that molecularly therapy may improve survival in patients with advanced or recurrent endometrial cancer.
However, these findings should be validated in randomized trials, according to Angeles Alvarez Secord, MD, of Duke University Medical Center in Durham, North Carolina.
Dr Alvarez Secord presented the findings at the SGO 2022 Annual Meeting on Women’s Cancer.
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The data come from the Endometrial Cancer Molecularly Targeted Therapy Consortium, a national multidisciplinary consortium of translational and clinical investigators studying advanced and recurrent endometrial cancer.
Dr Alvarez Secord presented data on 994 patients treated at 12 centers. The patients’ median age was 64 (range, 22-93) years. The cohort was 67.2% White, 22.7% Black, 2.4% Asian, and 3.0% Hispanic.
Endometrioid was the most common histologic subtype (49.7%), followed by serous (20.2%), carcinosarcoma (10.9%), and clear cell (3.7%). Patients had stage I (25.8%), II (4%), III (37.6%), or IV (24.4%) disease. The median number of prior regimens they received was 2 (range, 0-9).
Genomic Landscape, Matched Therapy
Next-generation sequencing was performed in 764 patients. The researchers looked specifically for 10 alterations they thought might be actionable, and more than 54% of patients had at least 1 potentially actionable alteration.
The most common alterations were observed in PI3K (31.5%), TP53 (30.5%), and PTEN (25.4%). The remainder included CTNNB1 (7.2%), AKT (2.3%), ESR (1.4%), mTOR (1.1%), TSC2 (0.8%), and POLE (0.6%). In addition, 6.1% of patients had a high tumor mutational burden.
Of the patients with actionable alterations, 244 ultimately received 308 matched therapies. With a median follow-up of 26.2 months, 44.8% of patients had received a checkpoint inhibitor alone or in combination, 31.5% had received hormone therapy, 10.7% had received everolimus and letrozole, and 7.5% had received trastuzumab.
For the entire matched cohort, the median progression-free survival (PFS) was 7.6 months, and the median overall survival (OS) was 24.4 months.
Dr Alvarez Secord compared these outcomes to PFS and OS data from the KEYNOTE-775 trial (ClinicalTrials.gov Identifier: NCT03517449). In that trial, the median PFS was 7.2 months with lenvatinib plus pembrolizumab and 3.8 months with chemotherapy. The median OS was 18.3 months and 11.4 months, respectively.
“This consortium has facilitated the development of real-world data regarding patterns of genomic testing and the use of molecularly targeted therapies in patients with metastatic endometrial cancer,” Dr Alvarez Secord said.
“The platform allowed for inclusion of a racially and geographically diverse patient population, and I am hopeful this effort has a chance to better define the role of targeted therapy in patients with endometrial cancer. The matched therapy data was really promising but definitely needs to be confirmed, hopefully in the context of a biomarker-specified clinical trial.”
Disclosures: Dr Alvarez Secord disclosed relationships with Abbie, Aravive, AstraZeneca, Clovis, Eisai, GSK, Merck, Myriad, Onconova, Oncoquest, Regeneron, Roche/Genentech, Seagen, TapImmune, VBL, and the National Cancer Trial Network.
Read more of Cancer Therapy Advisor’s coverage of SGO 2022 by visiting the conference page.
Reference
Alvarez Secord A, Pothuri B, Backes F, et al. Genomic alterations, molecularly targeted therapy and race: Real world data from the Endometrial Cancer Molecularly Targeted Therapy Consortium. Presented at SGO 2022; March 18-21, 2022. Abstract LBA 8.
