In patients with recurrent endometrial carcinoma, how do you decide when to offer Carboplatin/Paclitaxel +/- pembrolizumab or dostarlimab (NRG-GY018/RUBY) versus Lenvatinib/Pembrolizumab (KEYNOTE-775)?
Which is your preferred regimen for recurrent endometrial carcinoma?
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I take into account prior therapy regimen in the upfront setting, time to recurrence, burden of disease for pMMR recurrence, and of course, patient characteristics--can they tolerate chemotherapy (again) or how concerned I am about lenvatinib toxicity in said patient? If they have not had chemotherapy before then I usually will start with that and discuss the addition of immunotherapy. If they have had chemotherapy before, especially within the last six months, I will tend to use len-pem regimen (or referral to a clinical trial).
Below is my quick summary of the results of the two trials with PFS and OS data in the pMMR patient population.
Recall that in the RUBY trial, eligible patients were patients with primary advanced stage III or IV o...
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