In a case report, a patient diagnosed with dedifferentiated endometrial carcinoma (DDC), a rare and aggressive subtype of endometrial cancer, underwent primary surgery followed by chemotherapy and a short course of pembrolizumab. She achieved a prolonged disease-free survival of 61 months. Despite the limited inclusion of patients with DDC in recent trials, which primarily focused on measurable disease, this case suggests a potential benefit of pembrolizumab in treating advanced-stage, unmeasurable DDC. The findings underscore the need for further exploration of PD-1 blockade in this subtype and highlight the potential for integrating immunotherapy into upfront treatment strategies for high-risk endometrial cancers.
While pembrolizumab has shown promising results in treating advanced endometrial cancer, including in patients with mismatch repair deficiency, optimal treatment duration remains uncertain. This case report suggests that even a short course of pembrolizumab following chemotherapy could lead to long-term disease-free survival. However, it also raises questions about the balance between treatment efficacy and the risk of immune-related toxicities and cost.
Reference: Davis JM, Rushton T, Nsiah F, et al. Long-term disease-free survival with chemotherapy and pembrolizumab in a patient with unmeasurable, advanced stage dedifferentiated endometrial carcinoma. Gynecol Oncol Rep. 2024;53:101380. doi: 10.1016/j.gore.2024.101380.
