Immunonkologie: Neues zum Endometrium‑, Zervix- und triple-negativen Mammakarzinom

Abstract

Immunotherapy has gained increasing importance in the treatment of gynecologic cancer in past years. Recently published data have opened the door to new treatment strategies in gyno-oncology. The current review article presents an overview of up-to-date clinical immuno-oncologic data in endometrial, cervical, and triple-negative breast cancer (TNBC). In the KEYNOTE-775 trial, the combination pembrolizumab/lenvatinib improved survival compared to established second-line chemotherapies. These data led to approval of this combination therapy for advanced/recurrent endometrial cancer. Based on the results of the GARNET study, for the same indication with the additional presence of mismatch repair deficiency (MMRd) or microsatellite instability, monotherapy with dostarlimab is the new treatment standard following platin-based chemotherapy. For cervical cancer, based on the positive results of the KEYNOTE-826 trial, the combination of platin-based first-line chemotherapy with the immune checkpoint inhibitor pembrolizumab is the new standard for first-line treatment of persistent, recurrent, or metastatic programmed cell death 1 ligand 1 (PD-L1)-positive cervical cancer. In TNBC, the immune checkpoint inhibitor pembrolizumab is a standard component of medical therapy in the neoadjuvant as well as the palliative setting: the KEYNOTE-522 trial led to approval of pembrolizumab in combination with dose-intense platin-based neoadjuvant chemotherapy for TNBC regardless of PD-L1 status. In the metastatic situation, based on the data of the KEYNOTE-355 trial, pembrolizumab is approved in the case of a positive PD-L1 status (combined positive score [CPS] ≥ 10) in combination with chemotherapy. Further analyses of study data are expected to extend the immune-oncologic armamentarium by novel combination therapies in the near future.