臨床婦人科産科77巻9号

2023年09月発行

今月の臨床 専攻医必携！　免疫チェックポイント阻害薬が変える子宮がん診療 子宮体がん編

今後の展望―注目される臨床試験など

著者： 西尾真¹

所属機関： ¹久留米大学医学部産科婦人科学教室

ページ範囲：P.924 - P.929

●GY018試験とRUBY試験の良好な結果を受け，一次治療にも免疫チェックポイント阻害薬（ICIs）の導入が見込まれる．

●また，ICIsとPARP阻害薬を併用した試験結果も期待される．

●さらにdMMR/MSI-highを対象として，化学療法vs. ICIsの試験も行われている．

参考文献

1）Mirza MR, et al : Dostarlimab for primary advanced or recurrent endometrial cancer. N Engl J Med 388 : 2145-2158, 2023

2）Miller DS, et al : Carboplatin and paclitaxel for advanced endometrial cancer : final overall survival and adverse event analysis of a phase III trial（NRG Oncology/GOG0209）. J Clin Oncol 38 : 3841-3850, 2020

3）Eskander RN, et al : Pembrolizumab plus chemotherapy in advanced endometrial cancer. N Engl J Med 388 : 2159-2170, 2023

4）Colombo N, et al : AtTEnd/ENGOT-en7 : a multicenter phase III double-blind randomized controlled trial of atezolizumab in combination with paclitaxel and carboplatin in women with advanced/recurrent endometrial cancer. Ann Oncol 31 （Suppl 4） : S647, 2020

5）Westin SN, et al : DUO-E/GOG-3041/ENGOT-EN10 : a randomized phase III trial of first-line carboplatin（carb）and paclitaxel（pac）in combination with durvalumab（durva）, followed by maintenance durva with or without olaparib（ola）, in patients（pts）with newly diagnosed（nd）advanced or recurrent endometrial cancer（EC）. J Clin Oncol 38（Suppl）, 2020

6）Mirza MR, et al : ENGOT-EN6/GOG-3031/NSGO-CTU-RUBY part 2 : a phase III, randomized, double-blind, study of dostarlimab+carboplatin-paclitaxel followed by dostarlimab+niraparib versus placebo（PBO）+carboplatin-paclitaxel followed by PBO in recurrent or advanced endometrial cancer（EC）. Ann Oncol 32（Suppl 5） : S770-S771, 2021

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8）Slomovitz B, et al : KEYNOTE-C93/GOG-3064/ENGOT-en15 : a phase 3, randomized, open-label study of first-line pembrolizumab versus platinum-doublet chemotherapy in mismatch repair deficient advanced or recurrent endometrial carcinoma. J Clin Oncol 40（Suppl 16） : TPS5623, 2022

9）U.S. National Library of Medicine, Clinical Trials.gov : Endometrial cancer patientes MMR deficient comparing chimiotherapy vs dostarlimab in first line（DOMENICA）. https://clinicaltrials.gov/ct2/show/NCT05201547

10）Van Gorp T, et al : ENGOT-en11/GOG-3053/KEYNOTE-B21 : phase 3 study of pembrolizumab or placebo in combination with adjuvant chemotherapy with/without radiotherapy in patients with newly diagnosed high-risk endometrial cancer. J Clin Oncol 39（Suppl 15）, 2021

11）RAINBO Research Consortium : Refining adjuvant treatment in endometrial cancer based on molecular features : the RAINBO clinical trial program. Int J Gynecol Cancer 33 : 109-117, 2022

12）Cancer Genome Atlas Research Network ; Kandoth C, et al : Integrated genomic characterization of endometrial carcinoma. Nature 497 : 67-73, 2013