An overview of ongoing research in the endometrial cancer treatment space.
Ritu Salani, MD, MBA: The other complexity is that several other abstracts presented at this meeting looked at I/O [immuno-oncology] combinations, mostly checkpoint inhibitors. There was adalimumab-axitinib, which was presented in the mismatch repair [MMR]–proficient population, in recurrent or persistent endometrial cancer. There’s apatinib-camrelizumab. There’s cediranib-olaparib, olaparib-durvalumab, or cediranib-durvalumab in women with recurrent persistent ovarian cancer. We’re seeing similar concepts with different agents being explored. I’d love to hear your take on those studies. They’re informative, but they’re challenged because of this new shifting landscape. I’ll open it up to the panel if you want to take any trial that was presented.
Shannon N. Westin, MD, MPH, FACOG: Several of those trials are ongoing. GY012 was doing olaparib in various combinations and durvalumab in various combinations. That’s in the second line in patients who haven’t had I/O, a PARP inhibitor, or anything else. If there’s intriguing activity, those types of things might get moved into earlier lines of therapy. To that point, we’re already awaiting the results of DUO-E, a randomized phase 3 trial that has 3 arms. Similar to GY018 and RUBY, it has an arm of a PD-L1 inhibitor compared with placebo, but the third arm takes durvalumab and adds olaparib to it. The results are in, but we don’t have them yet. The press release notes that the primary end points are positive for both arms, both the durvalumab-alone arm as well as the durvalumab-olaparib arm. That will be presented soon and will determine if that’s going to impact our care of patients who are not only the mismatch repair deficient but also proficient, depending on the impact of that regimen.
Ursula A. Matulonis, MD: That will be interesting to see. But that’s the perfect study to set the standard of care around whether we’re going to use PARP inhibitors in this setting and the best patient population.... Endometrial cancers have underlying HRD [homologous recombination deficiency]. I’ll comment on the 2 other trials that were that were presented. One was presented in the plenary session on the combination of I/O and VEGF inhibition. From our group, Betsy Lee presented avelumab and axitinib in a poster. Both trials, much like lenvatinib-pembrolizumab, have very significant response rates. About 40% are really benefiting. These trials confirm the activity of pembrolizumab-lenvatinib.
Ritu Salani, MD, MBA: Can you talk a little about RUBY Part 2?
Matthew A. Powell, MD: RUBY Part 2 adds in those additional arms to add in a PARP inhibitor and niraparib with dostarlimab as a maintenance strategy for patients after carboplatin-paclitaxel. Like in RUBY, they get dostarlimab with carboplatin-paclitaxel, and you add in the niraparib after. That has completed accrual, and we should have data in the next year. We hope the MMR-proficient population, as we would guess, is going to benefit from the addition of a PARP inhibitor. It’s yet to be seen. This is 1 more area in which we try to understand how best to personalize medicine for our patients.
Transcript edited for clarity.