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Topics:
Gynecologic Cancers • Endometrial Cancer • Medical Oncology • ASCO Journal Club • Journal Club ft. NEJM publications • Gynecologic Oncology
Would you consider offering immunotherapy +/- olaparib to a patient with early-stage endometrial carcinoma for whom you are recommending adjuvant chemotherapy based on improved outcomes seen in RUBY/DUO-E/NRG-GY018?
If yes, would you apply this broadly or reserve the addition of IO to chemotherapy for patients with high-risk histologies (e.g., carcinosarcoma) or other factors?
Answer from: at Community Practice
I hesitate to offer the chemo/IO combination to patients with stage I disease as this is likely an overtreatment. The majority of the patients who require chemotherapy for stage I disease are those with serous and carcinosarcoma histology. Most of those patients are not even MMRd. It is unclear what...
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Answer from: at Community Practice
Because high risk Stage I patients were not included in these trials (serous, carcinsarcoma, clear cell, mixed histologies), I don't typically recommend the addition of IO to chemotherapy for early stage disease. We will likely see this data for the dMMR early stage patients in future trials.