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Updated: Sep 5, 2025
Author Spotlight: Advancing Reproductive Immunology with a Protocol for the Quantitative Evaluation of Endometrial Immune Cells
Published on: October 13, 2023
Immune Checkpoint Inhibitors and Mismatch Repair Status in Advanced Endometrial Cancer: Elective Affinities
1Struttura Semplice Dipartimentale di Oncologia Medica per la Presa in Carico Globale del Paziente Oncologico "Don Tonino Bello", I.R.C.C.S. Istituto Tumori "Giovanni Paolo II", Viale Orazio Flacco 65, 70124 Bari, Italy.
Abstract:
Since endometrial cancers (ECs) are frequently TMB-H and MSI-H/dMMR tumors, this element has provided the rationale for testing immune checkpoint inhibitors (ICIs), which have recently emerged as a potential game-changer. However, several questions remain to be addressed, including the identification of patients who may benefit from the addition of ICIs as well as those who do not need immunotherapy. In the current paper, we provide an overview of the clinical development of immunotherapy in advanced or recurrent EC, discussing the role of MMR and the "elective affinities" between ICIs and this predictive biomarker in this setting.
Insights
Endometrial cancers (ECs) are often TMB-H and MSI-H/dMMR, making immune checkpoint inhibitors (ICIs) promising. This review discusses immunotherapy in advanced EC, focusing on mismatch repair (MMR) and patient selection for ICI therapy.
Area of Science:
- Oncology
- Immunology
- Genetics
Background:
- Endometrial cancers (ECs) frequently exhibit high tumor mutational burden (TMB-H) and microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR) profiles.
- These molecular features provide a rationale for the clinical investigation of immune checkpoint inhibitors (ICIs).
- ICIs represent a potential paradigm shift in the treatment of advanced or recurrent EC.
Purpose of the Study:
- To provide an overview of the clinical development of immunotherapy in advanced or recurrent endometrial cancer.
- To discuss the role of mismatch repair (MMR) status as a predictive biomarker for ICI efficacy.
- To explore the relationship between ICIs and MMR biomarkers in this patient population.
Main Methods:
- Review of clinical trial data and scientific literature on immunotherapy in advanced or recurrent EC.
- Analysis of the predictive value of MSI-H/dMMR status in response to ICIs.
- Discussion of the biological rationale for ICI activity in EC.
Main Results:
- Immune checkpoint inhibitors have shown promise in treating advanced or recurrent EC, particularly in patients with MSI-H/dMMR tumors.
- MMR status is a key predictive biomarker for ICI response in EC.
- Further research is needed to refine patient selection and optimize ICI therapy.
Conclusions:
- Immunotherapy, specifically ICIs, is a significant advancement for patients with advanced or recurrent EC, especially those with MSI-H/dMMR.
- Understanding the interplay between ICIs and MMR biomarkers is crucial for personalized treatment strategies.
- Identifying patients who will benefit most from ICIs, and those who may not require immunotherapy, remains an important clinical challenge.
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