Complete radiological response when using pembrolizumab in the mono mode in the 2nd-line drug therapy of MSI-h / dMMR-positive advanced endometrial cancer. A clinical case

Abstract

Until recently, the prognosis of patients with advanced endometrial cancer remained disappointing despite the standard treatment methods. None of the drugs in the arsenal of oncologists-chemotherapists provided long-term disease control and long-term survival of patients who received standard platinum-containing first-line chemotherapy. It is obvious that the poor results of treatment in patients with advanced endometrial cancer required a change in treatment approaches and indicated the need to develop more effective treatment regimens. A deeper understanding of the mechanisms of carcinogenesis, the emergence of new molecular classification of endometrial cancer and division of treatment approaches depending on the tumor biological potential has led to significant breakthrough in the treatment of advanced endometrial cancer. One of the most significant achievements is discovery of the function of microsatellite instability (MSI) and disorders in the repair system of unpaired bases of deoxyribonucleic acid (MMR) as a predictor of high efficient immunotherapy – a new direction of systemic drug therapy for the advanced endometrial cancer. The paper presents a clinical case of successful treatment of MSI-h / dMMR-positive advanced endometrial cancer using pembrolizumab as a second-line therapy (in the presence of refractoriness to standard platinum-based chemotherapy of the 1st line) in a mono mode with a complete radiological response of the tumor to treatment.