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Topics:
Radiation Oncology • Gynecologic Cancers • Endometrial Cancer • Medical Oncology • Immune Checkpoint Inhibitor
In patients with advanced endometrial cancer who you plan to treat with chemotherapy + immunotherapy (per GY018 or RUBY), how and when do you utilize adjuvant EBRT and/or brachytherapy?
Does the presence of parametrial or cervical involvement impact your decision?
How do you sequence treatment modalities?
Answer from: Radiation Oncologist at Academic Institution
Reading the question at face value - does advanced endometrial cancer mean stage IVB? III/IVA? If IVB, there is not routinely a role of 'adjuvant' EBRT or BT.Given the discussion of adjuvant therapy, I presume the question is asking for the small fraction of RUBY and GY-018 patients who were stage I...
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Answer from: Radiation Oncologist at Community Practice
In cases where a RUBY or 018 regimen is recommended for a patient outside the true inclusion criteria (NCCN lists them both as viable options for all stage III with the residual disease qualifier being relegated to a footnote and insurance seems to be playing along), I, at a minimum, push for vagina...
Answer from: Radiation Oncologist at Community Practice
GY018 was for stage III with measurable disease for endometrium histology and not truly adjuvant while RUBY allowed stage III2 endometroid adjuvant but was a small subset (18% or so) and pre-specified stratification didn’t reach PFS benefit in that subset. So in a true sense, it’s more f...