Top

Open Access 18-04-2024 | Endometrial Cancer | Gynecologic Oncology

Real-world prevalence of microsatellite instability testing and related status in women with advanced endometrial cancer in Europe

Authors: Sneha S. Kelkar, Vimalanand S. Prabhu, Jingchuan Zhang, Yoscar M. Ogando, Kyle Roney, Rishi P. Verma, Nicola Miles, Christian Marth

Published in: Archives of Gynecology and Obstetrics

Abstract

Purpose

To assess the real-world prevalence of microsatellite instability (MSI)/mismatch repair (MMR) testing and related tumor status in recurrent/advanced endometrial cancer patients in Europe.

Methods

Data were from two multi-center, retrospective patient chart review studies conducted in the United Kingdom, Germany, Italy, France and Spain: The Endometrial Cancer Health Outcomes-Europe-First-Line (ECHO-EU-1L) study and the ECHO-EU-Second-Line (ECHO-EU-2L) study. ECHO-EU-1L included recurrent/advanced endometrial cancer patients who received first-line systemic therapy between 1/JUN/2016 and 31/MAR/2020 after recurrent/advanced diagnosis. ECHO-EU-2L included patients with recurrent/advanced endometrial cancer who progressed between 1/JUN/2016 and 30/JUN/2019 following prior first-line systemic therapy. Data collected included patient demographics, MSI/MMR tumor testing and results, and clinical/treatment characteristics.

Results

ECHO-EU-1L included 242 first-line patients and ECHO-EU-2L included 475 s-line patients. For all patients, median age at recurrent/advanced diagnosis was 69 years, roughly half had endometrioid carcinoma histology and over 75% had Stage IIIB-IV disease at initial diagnosis. The prevalence of MSI/MMR testing in the first-line and second-line cohorts was similar (36.4 and 34.9%, respectively). Among those tested, a majority had non-MSI-high/MMR proficient tumors (80.7 and 74.7% among first- and second-line patients, respectively). About 15% had MSI-high/MMR deficient tumors in both cohorts, and a few patients had discordant results (3.4 and 10.8% among first- and second-line patients, respectively).

Conclusion

Prior to the approvals of biomarker-directed therapies for recurrent/advanced endometrial cancer patients in Europe, there were low MSI/MMR testing rates for these patients of just over one-third. Given the availability of biomarker-directed therapies, increased MSI/MMR testing may help inform treatment decisions for recurrent/advanced endometrial cancer patients in Europe.

Zhang S, Gong TT, Liu FH et al (2019) Global, regional, and national burden of endometrial cancer, 1990–2017: results from the global burden of disease study. Front Oncol 9:1440. https://doi.org/10.3389/fonc.2019.01440CrossRefPubMedPubMedCentral

(2020) The global cancer observatory Corpus uteri—international agency for research on cancer Corpus uteri. https://gco.iarc.fr/today/data/factsheets/cancers/24-Corpus-uteri-fact-sheet.pdf. Published December 2020. Accessed December 13, 2022.

Creasman WT, Odicino F, Maisonneuve P et al (2006) Carcinoma of the corpus uteri. Int J Gynaecol Obstet 95(Suppl 1):S105–S143. https://doi.org/10.1016/S0020-7292(06)60031-3CrossRefPubMed

Ries LAG, Young JL, Keel GE, Eisner MP, Lin YD, Horner M-J (2007) SEER survival monograph: cancer survival among adults: U.S. SEER program, 1988-2001, patient and tumor characteristics. Bethesda, MD, National Cancer Institute, SEER Program. https://seer.cancer.gov/archive/publications/survival/seer_survival_mono_lowres.pdf

Huijgens AN, Mertens HJ (2013) Factors predicting recurrent endometrial cancer. Facts Views Vis Obgyn 5(3):179–186PubMedPubMedCentral

Jeppesen MM, Jensen PT, Gilså Hansen D, Iachina M, Mogensen O (2016) The nature of early-stage endometrial cancer recurrence-A national cohort study. Eur J Cancer 69:51–60. https://doi.org/10.1016/j.ejca.2016.09.033CrossRefPubMed

Oaknin A, Bosse TJ, Creutzberg CL et al (2022) Endometrial cancer: ESMO clinical practice guideline for diagnosis, treatment and follow-up. Ann Oncol. https://doi.org/10.1016/j.annonc.2022.05.009CrossRefPubMed

Colombo N, Creutzberg C, Amant F et al (2016) ESMO-ESGO-ESTRO consensus conference on endometrial cancer: diagnosis, treatment and follow-up. Ann Oncol 27(1):16–41. https://doi.org/10.1093/annonc/mdv484CrossRefPubMed

Kang YJ, O’Haire S, Franchini F et al (2022) A scoping review and meta-analysis on the prevalence of pan-tumour biomarkers (dMMR, MSI, high TMB) in different solid tumours. Sci Rep 12(1):20495. https://doi.org/10.1038/s41598-022-23319-1CrossRefPubMedPubMedCentral

10.

GlaxoSmithKline European Commission approves GSK’s JEMPERLI (dostarlimab), the first anti-PD-1 therapy approved for recurrent or advanced endometrial cancer Published April 23, 2021. Accessed July 10, 2023. https://www.gsk.com/en-gb/media/press-releases/european-commission-approves-gsk-s-jemperli-dostarlimab-the-first-anti-pd-1-therapy-approved-for-recurrent-or-advanced-endometrial-cancer/

11.

ESMO. EMA Recommends Extension of Indications for Pembrolizumab to MSI-H or dMMR Cancers and to Metastatic Cervical Cancer with PD-L1 CPS ≥1. Published April 7, 2022. Accessed July 10, 2023. https://www.esmo.org/oncology-news/ema-recommends-extension-of-indications-for-pembrolizumab-to-msi-h-or-dmmr-cancers-and-to-metastatic-cervical-cancer-with-pd-l1-cps-1

12.

OncLive. Dostarlimab Plus Chemo Granted EU Approval for dMMR/MSI-H Endometrial Cancer. Published December 14, 2023. Accessed February 13, 2024. https://www.onclive.com/view/dostarlimab-plus-chemo-granted-eu-approval-for-dmmr-msi-h-endometrial-cancer

13.

Westin SN, Moore K, Chon HS et al (2024) Durvalumab plus carboplatin/paclitaxel followed by maintenance durvalumab with or without olaparib as first-line treatment for advanced endometrial cancer: the phase III DUO-E trial. J Clin Oncol 42(3):283–299. https://doi.org/10.1200/jco.23.02132CrossRefPubMed

14.

Marth C, Tarnawski R, Tyulyandina A et al (2022) Phase 3, randomized, open-label study of pembrolizumab plus lenvatinib versus chemotherapy for first-line treatment of advanced or recurrent endometrial cancer: ENGOT-en9/LEAP-001. Int J Gynecol Cancer 32(1):93–100. https://doi.org/10.1136/ijgc-2021-003017CrossRefPubMed

15.

Mirza MR, Chase DM, Slomovitz BM et al (2023) Dostarlimab for primary advanced or recurrent endometrial cancer. N Engl J Med 388(23):2145–2158. https://doi.org/10.1056/nejmoa2216334CrossRefPubMed

16.

Eskander RN, Powell MA (2021) Immunotherapy as a treatment strategy in advanced stage and recurrent endometrial cancer: review of current phase III immunotherapy clinical trials. Ther Adv Med Oncol 13:17588359211001200CrossRefPubMedPubMedCentral

17.

Ogando YM, Prabhu VS, Zhang J et al (2022) 2022-RA-712-ESGO Real-world prevalence of microsatellite instability testing and related status in patients with recurrent or advanced endometrial cancer initiating first line of therapy in Europe. Int J Gynecol Cancer 32:A105–A106

18.

Zhang J, Kelkar SS, Prabhu VS et al (2022) Abstract 6276: real-world prevalence of MSI/MMR testing for patients with recurrent or advanced endometrial cancer in Europe. Can Res 82(12_Supplement):6276–6276. https://doi.org/10.1158/1538-7445.Am2022-6276CrossRef

19.

Kelkar SS, Prabhu VS, Zhang J et al (2022) Treatment patterns and real-world clinical outcomes in patients with advanced endometrial cancer that are non-microsatellite instability high (non-MSI-high) or mismatch repair proficient (pMMR) in the United States. Gynecol Oncol Rep 42:101026. https://doi.org/10.1016/j.gore.2022.101026CrossRefPubMedPubMedCentral

20.

American College of Obstetricians and Gynocologists (2014) Practice bulletin No. 147: lynch syndrome [published correction appears in obstet gynecol. 2022 Apr 1;139(4):696]. Obstet Gynecol 124(5):1042–1054. https://doi.org/10.1097/01.AOG.0000456325.50739.72CrossRef

21.

Njoku K, Barr CE, Crosbie EJ (2022) Current and emerging prognostic biomarkers in endometrial cancer. Front Oncol 12:890908. https://doi.org/10.3389/fonc.2022.890908CrossRefPubMedPubMedCentral

Title: Real-world prevalence of microsatellite instability testing and related status in women with advanced endometrial cancer in Europe
Authors: Sneha S. Kelkar
Vimalanand S. Prabhu
Jingchuan Zhang
Yoscar M. Ogando
Kyle Roney
Rishi P. Verma
Nicola Miles
Christian Marth
Publication date: 18-04-2024
Publisher: Springer Berlin Heidelberg
Keywords: Endometrial Cancer
Endometrial Cancer
Biomarkers
Systemic Therapy
Published in: Archives of Gynecology and Obstetrics
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-024-07504-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Real-world prevalence of microsatellite instability testing and related status in women with advanced endometrial cancer in Europe

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Please log in to get access to this content