The Future of Immunotherapy: Advancing Care in Endometrial Cancer

ReachMD Announcer:
You’re listening to Project Oncology on ReachMD. On this episode, we’ll hear from Dr. Casey Cosgrove, who’s an Assistant Professor in the Department of Gynecologic Oncology at The Ohio State University College of Medicine and a member of the Translational Therapeutics Program at The Ohio State University Comprehensive Cancer Center. He’ll be sharing insights on the future of immunotherapy in endometrial cancer care. Here’s Dr. Cosgrove now.

Dr. Cosgrove:
The role of immunotherapy I would expect to continue to expand and be augmented in the future when we talk about treatment within endometrial cancer. Right now, immunotherapy is a critically important therapy for many patients with more advanced or recurrent endometrial cancer. And despite our extraordinary enthusiasm and positive clinical trials, we know there’s an opportunity to do better.

Even for mismatch repair-deficient tumors, which are the ones we would expect to have the greatest benefit from immunotherapy, in large trials like RUBY and GY18, we saw somewhere between a 20 to 40 percent primary or acquired resistance to immunotherapy. And these individuals we expect to have a great response, and then they don’t, and it’s so frustrating. So we’re looking at opportunities to identify who may or may not respond to immunotherapy, but also, how can we better augment immunotherapy to have better outcomes?

And I think we’re probably going to see immunotherapy expand in two directions. Number one, can we better understand who’s going to respond and who’s not going to respond? So maybe we could do a mono-immunotherapy approach for individuals or dual-immunotherapy approach for individuals? But then, if I have patients who we don’t expect to see as big of a response, is there some sort of opportunity where we can add something to immunotherapy to increase responsiveness? Because immunotherapy is so important, can we re-engage the immune system for those who haven’t had as big of a response as we were hoping for? And I think that will continue to be an area of interest.

Also, as we expand what immunotherapy means beyond just the immune checkpoint blockade, whether it’s cellular therapies, bispecifics, or other immunotherapy agents, that might give us an opportunity to have the best responses from an immune standpoint, hopefully leading to long-term durable responses.

The other thing with immunotherapy is, right now, we have a really poor understanding about who might have the biggest benefit from immunotherapy in that mismatch repair proficient group, which makes up somewhere between 70 to 75 percent of endometrial cancers. And we see there is some benefit for individuals, but understanding who is actually getting that benefit so we can make sure we’re avoiding immunotherapy toxicities if it’s not going to be helpful, but also maybe thinking about why the immunotherapy is not working—that could help lead to more novel combinations or better ways to take care of patients in the future.

ReachMD Announcer:
That was Dr. Casey Cosgrove discussing the expanding role of immunotherapy in endometrial cancer. To access this and other episodes in our series, visit Project Oncology on ReachMD.com, where you can Be Part of the Knowledge. Thanks for listening!