Biomarkers, targeted and immunotherapies for endometrial cancer
This section covers the following topics:
tests look at samples of blood, tumor or other tissue for changes or abnormalities caused by cancer. These tests can give doctors clues about the cancer, including:
- how fast the cancer is growing
- which treatments are most likely to work
- whether or not the cancer is responding to treatment or growing
- whether or not the cancer has come back after remission
Biomarkers for treatment selection
tests may be used to select treatments, and help patients avoid side effects from treatments that will not work for them. tests used to select a specific treatment are sometimes called "companion diagnostic tests." These tests may be done on tumor tissue or (in many cases) on blood. See our Testing section for more information.
- Experts recommend testing all endometrial cancers for an abnormality known as MSI-H (“ high") also known as "" ( or ).
- cancers are common in people with a gene mutation. People with advanced or MSI-high endometrial cancer may respond well to a type of known as an immune checkpoint inhibitor.
- People with advanced, recurrent endometrial cancer that is not MSI-H, may benefit from a combination of the , Lenvima (lenvatinib) and the agent Keytruda.
- Examples of additional tests used in endometrial cancer include:
- A rare type of endometrial cancer—known as a uterine sarcoma—may have a genetic change called an NTRK fusion, which can be found on tumor testing. Endometrial with an NTRK fusion may benefit from the Vitrakvi (larotrectinib).
- A known as an NTRK fusion is rare in colorectal cancer.
- Estrogen receptor testing is used for advanced and recurrent endometrial cancers.
- Her2neu testing is used to find advanced or recurrent endometrial cancers that may respond to Herceptin.
- Additional tumor testing may help identify people who are elegible for certain clinical trials.
Immunotherapies are cancer treatments that help the body’s immune system detect and attack cancer cells. There are several different categories of immunotherapies.
- Keytruda (pembrolizumab) is approved to treat tumors that have MSI-H or . It can also be used along with the targeted drug lenvatinib in women with advanced endometrial cancers that are not or MSI-H, usually after other treatments have been tried.
is still fairly new in the treatment of endometrial cancer. Currently, these agents are only prescribed if the cancer has recurred or as part of a clinical trial. Targeted therapies for endometrial cancer include:
- Vitrakvi (larotrectinib) is approved for treatment of endometrial cancer that is or cannot be removed with surgery and has worsened with other treatments. It targets a specific genetic change called an NTRK fusion. This type of genetic change is found in a range of cancers, including a rare type of uterine cancer known as uterine sarcoma.
- Lenvima (lenvatinib) helps block tumors from forming new blood vessels. Lenvima can be used along with the drug Keytruda to treat some advanced endometrial cancers, typically after at least one other drug treatment has been tried.
- Afinitor (everolimus) is a type of known as an mTOR inhibitor that has been used (off label) to treat some people with advanced endometrial cancer. Afinitor does not have approval for use in endometrial cancer.
- Avastin (bevacizumab) helps block tumors from forming new blood vessels. Avastin does not have approval for use in endometrial cancer.
Table of targeted and immunotherapies for endometrial cancer
|Name of drug||Type of agent||Cancer||Indication|
|Jemperli (dostarlimab)||Immune checkpoint inhibitor||Recurrent or advanced endometrial cancer||For treatment of recurrent or advanced endometrial cancer that is mismatch repair deficient () that has progressed on or following a prior platinum-containing regimen.||VENTANA MMR RxDx Panel|
||Immune checkpoint inhibitor
||or unresectable||For treatment of that have progressed after treatment and for which there are no other treatment options||High (MSI-H) or ()|
|or unresectable||For the treatment of that have progressed after treatment and for which there are no other treatment options||High (TMB-H)|
|Advanced endometrial cancer||Combined with Lenvima (lenvatinib) for patients whose cancer has progressed after treatment and who are not candidates for surgery or radiation||Tumor is not MSI-H or|
|Tyrosine kinase inhibitor||Advanced endometrial cancer||
Combined with pembrolizumab, for the treatment of women whose cancer has progressed after treatment and who are not candidates for surgery or radiation
|Tumor is not MSI-H or|
|Vitrakvi (larotrectinib)||Kinase inhibitor||solid tumors||For treatment in solid tumors where surgical resection is likely to result in severe , and for which there are no satisfactory alternative treatments or the cancer progressed following treatment||NTRK fusion|
The following organizations offer peer support services for people with or at high risk for endometrial cancer:
- FORCE peer support
- Our Message Boards allow people to connect with others who share their situation. Once you register, you can post on the Diagnosed With Cancer board to connect with other people who have been diagnosed.
- Peer Navigation Program will match you with a volunteer who shares your mutation and situation.
- Private Facebook Group.
- Virtual and in-person support meetings.
- Join a Zoom community group meeting.
- SHARE is a nonprofit that provides support and information for women with breast, ovarian or endometrial cancer.
ECANA is an online resource for Black people with endometrial cancer.
The following are studies enrolling people with advanced endometrial cancer.
- NCT03607890: Nivolumab and Relatlimab in Advanced MSI-H Cancers Resistant to Prior PD-(L)1 Inhibitor. This study will evaluate the safety, effectiveness, and tolerability of the drugs nivolumab and relatlimab in patients with high (MSI-H) resistant to prior PD-(L)1 therapy.
- NCT03955978: TSR-042 in Addition to Standard of Care Definitive Radiation for Inoperable Endometrial Cancer. The purpose of this Phase 1 trial is to evaluate dostarlimab (also known as TSR-042) compared to standard of care radiation therapy for patients with inoperable endometrial cancer to establish the safety and efficacy of inducing an anti-tumor immune response.
- NCT04106414: Study of BMS-986205 and Nivolumab in Endometrial Cancer or Endometrial Carcinosarcoma That Has Not Responded to Treatment. This study will compare the effects of treatment with the nivolumab alone to nivolumab plus the experimental drug BMS-986205.
- NCT04463771: Safety and Efficacy of Retifanlimab (INCMGA00012) Alone or in Combination With Other Therapies in Participants With Advanced or Endometrial Cancer Who Have Progressed on or After Platinum-based Chemotherapy. (POD1UM-204). This is a Phase 2 study of the PD-1 antibody retifanlimab in participants who have advanced or endometrial cancer that has progressed on or after platinum-based chemotherapy.
- NCT03241745: A Study of Nivolumab in Selected Uterine Cancer Patients. This study will test how safe, effective, and tolerable nivolumab is for people with or recurrent uterine cancer.
A number of other clinical trials for patients with endometrial cancer can be found here.