SUMMARY

Over the past decade, immune checkpoint inhibitors (ICI) emerged as a new therapeutic pillar across a broad range of cancer types. An important characteristic of patients responding to ICI-based therapy consists of a high mutational burden in the tumours. In line with this, patients with microsatellite instability-high or mismatch repair-deficient (MSI-H/dMMR) endometrial cancer (EC) proved to be particularly sensitive to ICI, leading to the approval of anti-PD-1 antibodies for patients with MSI-H/dMMR ≥2nd line recurrent setting. Responses to single-agent ICI have also been reported in a small proportion of patients with microsatellite stable (MSS) EC. However, a high unmet need remains for these patients. More recently, several phase III randomised controlled trials showed that adding an ICI to standard chemotherapy significantly delays the disease progression in patients with primary advanced or recurrent MSI-H/dMMR EC, but also, to a lesser extent, in MMR proficient (p)/MSS EC. This article will briefly review the available clinical trial data with ICI-based therapies in EC and will assess how this treatment modality could be integrated into the Belgian treatment paradigm for these patients.

(BELG J MED ONCOL 2024;18(2):49–59)