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Randomized evidence has shown that immune-checkpoint inhibition can produce substantial benefit in advanced or recurrent endometrial cancer, particularly in tumors with mismatch repair deficiency or microsatellite instability. The KEYNOTE-158 and related studies established durable responses to pembrolizumab in biomarker-selected populations, while later randomized trials expanded the role of immunotherapy in first-line treatment. For clinicians, tumor molecular classification is therefore increasingly central to management. Testing for mismatch repair proteins or microsatellite instability can identify patients most likely to benefit from immune checkpoint blockade and can also flag potential hereditary Lynch syndrome. Treatment requires monitoring for immune-related adverse events affecting the thyroid, liver, bowel, lung and other organs. The practical implication is that gynecologic oncology is moving toward integrated histologic, molecular and clinical decision-making.
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Randomized evidence has shown that immune-checkpoint inhibition can produce substantial benefit in advanced or recurrent endometrial cancer, particularly in tumors with mismatch repair deficiency or microsatellite instability. The KEYNOTE-158 and related studies established durable responses to pembrolizumab in biomarker-selected populations, while later randomized trials expanded the role of immunotherapy in first-line treatment. For clinicians, tumor molecular classification is therefore increasingly central to management. Testing for mismatch repair proteins or microsatellite instability can identify patients most likely to benefit from immune checkpoint blockade and can also flag potential hereditary Lynch syndrome. Treatment requires monitoring for immune-related adverse events affecting the thyroid, liver, bowel, lung and other organs. The practical implication is that gynecologic oncology is moving toward integrated histologic, molecular and clinical decision-making.
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