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PD-1/PD-L1 Inhibitors Monotherapy for the Treatment of Endometrial Cancer: Meta-Analysis and Systematic Review
Yun Dai1, Munawaer Muaibati1, Weiming Xie2
1Department of Gynecological Oncology, Tongji Hospital of Huazhong University of Science and Technology, Wuhan, China.
Purpose:
The efficacy of programmed cell death protein 1(PD-1)/Programmed cell death 1 ligand 1 (PD-L1) inhibitors for endometrial cancer remain controversial, and guidelines are inconsistent on which are preferred therapies for advanced disease, or who develop metastases and recurrence. Therefore, we aimed to estimate the efficacy and safety of PD-1/PD-L1 inhibitors in endometrial cancer on a more complete database by adding multiple randomized trials.
Methods:
A systematic and comprehensive search was carried out in PD-1/PD-L1 inhibitors monotherapy.
Results:
The ORR of PD-1/PDL-1 inhibitors was 29%, and subgroup analysis showed that the pooled ORR of the proficient mismatch repair (pMMR) group was 4% and which was 45% of the deficient mismatch repair (dMMR) group. The DCR of PD-1/PD-L1 inhibitors was 48%, through subgroup analysis, we found that the DCR of the pMMR group was 21% and which was 58% of the dMMR group. The proportion of patients occurring overall adverse events was 65% and grade three or higher adverse events was 14%. The proficient mismatch repair (pMMR) group and the deficient mismatch repair (dMMR) group showed different results.
Conclusion:
PD-1/PD-L1 inhibitors had shown little success in the pMMR population and better efficacy in the dMMR population.
Insights
Programmed cell death protein 1 (PD-1)/Programmed cell death 1 ligand 1 (PD-L1) inhibitors show limited efficacy in proficient mismatch repair (pMMR) endometrial cancer but improved outcomes in deficient mismatch repair (dMMR) populations.
Area of Science:
- Oncology
- Immunotherapy
- Gynecologic Oncology
Background:
- Endometrial cancer treatment efficacy for advanced disease, metastases, and recurrence using PD-1/PD-L1 inhibitors remains controversial.
- Clinical guidelines offer inconsistent recommendations for preferred therapies.
Purpose of the Study:
- To evaluate the efficacy and safety of PD-1/PD-L1 inhibitors in endometrial cancer.
- To synthesize data from multiple randomized trials for a comprehensive analysis.
Main Methods:
- A systematic and comprehensive literature search was performed.
- Analysis focused on PD-1/PD-L1 inhibitors used as monotherapy.
Main Results:
- The overall response rate (ORR) was 29%. Subgroup analysis revealed an ORR of 4% for the proficient mismatch repair (pMMR) group and 45% for the deficient mismatch repair (dMMR) group.
- The disease control rate (DCR) was 48%, with 21% for pMMR and 58% for dMMR.
- Adverse events occurred in 65% of patients, with 14% experiencing grade three or higher events. Significant differences were observed between pMMR and dMMR groups.
Conclusions:
- PD-1/PD-L1 inhibitors demonstrate limited efficacy in the pMMR endometrial cancer population.
- These inhibitors show greater efficacy in the dMMR endometrial cancer population.
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