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Efficacy of dostarlimab in recurrent or advanced mismatch Repair-Deficient endometrial Cancer as a Single-Agent

Ramazan Rezaei1, Hedieh Haji Khodaverdi Khani2

  • 1Department of Immunology, Medical Faculty, Shahed University, P.O. Box 14155-9853, Tehran, Iran. r.rezaei@shahed.ac.ir.

Daru : Journal of Faculty of Pharmacy, Tehran University of Medical Sciences
|July 5, 2025
PubMed
Abstract

Insights

Dostarlimab shows limited effectiveness for endometrial cancer (EC) with proficient mismatch repair (pMMR). However, it offers better outcomes for patients with deficient mismatch repair (dMMR) EC, indicating a targeted therapeutic potential.

Area of Science:

  • Oncology
  • Immunotherapy
  • Gynecologic Oncology

Background:

  • Endometrial cancer (EC) treatment efficacy, particularly with PD-1 inhibitors, is debated.
  • Clinical guidelines lack consensus on optimal strategies for advanced, metastatic, or recurrent EC.
  • There is a need for comprehensive data on PD-1 inhibitor efficacy in EC.

Purpose of the Study:

  • To evaluate the efficacy of Dostarlimab, a programmed cell death protein 1 (PD-1) inhibitor, in treating endometrial cancer (EC).
  • To synthesize data from clinical trials to establish a robust database for assessing Dostarlimab's impact on EC.
  • To compare outcomes between EC patients with proficient mismatch repair (pMMR) and deficient mismatch repair (dMMR) statuses.

Main Methods:

  • Systematic literature search across Scopus, Medline, Embase, and Web of Science databases.
  • Inclusion of all eligible clinical studies investigating Dostarlimab's efficacy in EC.
  • Meta-analysis of pooled data to determine overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and disease control rate (DCR).

Main Results:

  • The pooled hazard ratio for OS was 43%, and for PFS was 0.39 (95% CI: 0.31-0.49).
  • The overall analysis indicated a 72.71% probability of remaining in response (95% CI: 60.94-84.49%).
  • Objective response rate (ORR) was 33.93% (95% CI: 21.49-46.37%) and disease control rate (DCR) was 51.73% (95% CI: 37.0-66.42%), with superior outcomes observed in the dMMR subgroup compared to the pMMR subgroup. Median PFS in the dMMR group was 7.86 months (95% CI: 4.46-11.26).

Conclusions:

  • Dostarlimab demonstrates limited efficacy in endometrial cancer patients with proficient mismatch repair (pMMR).
  • Dostarlimab shows improved outcomes in patients with deficient mismatch repair (dMMR) endometrial cancer.
  • The findings suggest Dostarlimab's potential as a targeted therapy for dMMR EC.
Keywords:
Clinical trialsDeficient mismatch repairDostarlimabEndometrial cancerPD1 inhibitorsdMMR

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