Evaluation of Efficacy and Adverse Events After Second Immunotherapy Exposure in Endometrial and Cervical Carcinoma

Immunotherapy has changed the treatment paradigm for gynecologic malignancies. The RUBY (NCT03981796) and NRG-GY018 (NCT03914612) studies have shown significant improvements in survival for immunotherapy in combination with chemotherapy in advanced and recurrent endometrial cancer, and immunotherapy likely will become the first-line standard-of-care therapy. However, the efficacy of repeated exposure to immunotherapy for gynecologic cancers is unknown. In this retrospective series, 11 patients with endometrial cancer and four patients with cervical cancer were identified who received subsequent immunotherapy after first immunotherapy. With subsequent immunotherapy, three patients (20.0%) had complete response, three (20.0%) had partial response, three (20.0%) had stable disease, and six (40.0%) had disease progression; progression-free survival was similar to first-line immunotherapy. These data provide proof of concept for subsequent treatment with immunotherapy in gynecologic cancers, specifically endometrial cancer.