Endometrial Cancer: Targeted and Immunotherapies

What is immunotherapy? 

Immunotherapies are cancer treatments that help the body’s immune system detect and attack cancer cells. Immune checkpoint inhibitors are a type of immunotherapy used to treat several types of cancer, including endometrial cancer. Some cancer cells can switch off the immune system. Immune checkpoint inhibitors are drugs that prevent this from happening. This allows the immune system to find, unmask and destroy cancer cells.  

Which immunotherapies are used for endometrial cancer? 

Immune checkpoint inhibitors are used in the advanced or metastatic setting, most often to treat cancers that have biomarkers known as MSI-H or dMMR. People with Lynch syndrome often develop cancers with these biomarkers. The immunotherapies used in endometrial cancer include: 

• Imfinzi (durvalumab) is used in combination with chemotherapy followed by Imfinzi alone as first line treatment for advanced or recurrent dMMR endometrial cancer. 
• Jemperli (dostarlimab) is used in combination with chemotherapy followed by Jemperli alone as first line treatment for advanced or recurrent endometrial cancer. Jemperli may be used in this setting regardless of MSI/MMR status. 
• Jemperli is used alone to treat MSI-H or dMMR advanced or recurrent endometrial cancer, which came back or got worse after platinum chemotherapy. 
• Keytruda is used alone to treat MSI-H or dMMR advanced or recurrent endometrial cancer, in people whose cancer came back or got worse after previous treatment and who are not candidates for curative surgery or radiation. 
• Keytruda is used alone to treat advanced cancers with the biomarker tumor mutational burden-High (TMB-H) that have progressed after treatment and for which there are no other treatment options.
• Keytruda (pembrolizumab) is used to in combination with the targeted drug lenvatinib in women with advanced endometrial cancers that are not dMMR or MSI-H, usually after other treatments have been tried.

Immunotherapy side effects

Like any medication, immunotherapy can come with side effects. Most are manageable, but some can be serious or even life threatening. You can learn more about on our Immunotherapy Side Effects page. 

What is targeted therapy?

Targeted therapies are treatments designed to attack or kill cancer cells, while sparing normal cells as much as possible. These therapies are often designed to target abnormal proteins, receptors or genes that are found in high quantities in cancer cells or the surrounding tissue. Tumor biomarker testing can help doctors identify the patients most likely to benefit from a targeted therapy.

Which targeted therapies are used for endometrial cancer?

Targeted therapy is still fairly new in the treatment of endometrial cancer. Currently, these agents are only prescribed if the cancer has recurred or as part of a clinical trial. Targeted therapies for endometrial cancer include:

• Vitrakvi (larotrectinib) is approved for treatment of endometrial cancer that is metastatic or cannot be removed with surgery and has worsened with other treatments. It targets a specific genetic change called an NTRK fusion. This type of genetic change is found in a range of cancers, including a rare type of uterine cancer known as uterine sarcoma.
• Lenvima (lenvatinib) helps block tumors from forming new blood vessels. Lenvima can be used along with the immunotherapy drug Keytruda to treat some advanced endometrial cancers, typically after at least one other drug treatment has been tried.
• Afinitor (everolimus) is a type of targeted therapy known as an mTOR inhibitor that has been used (off label) to treat some people with advanced endometrial cancer. Afinitor does not have FDA approval for use in endometrial cancer. 
• Avastin (bevacizumab) helps block tumors from forming new blood vessels. Avastin does not have FDA approval for use in endometrial cancer. 
• Enhertu (trastuzumab deruxtecan) is a type of targeted therapy approved for treatment many different types of advanced cancers (including endometrial cancer) if tumor testing shows a biomarker called HER2-positive. 

Speak with your doctor if you have advanced endometrial cancer and you are not sure if you had biomarker testing, or if you don't understand your test results.

Researchers are studying new ways to use targeted therapies to treat endometrial cancer. Visit our Featured Research section for more information.

Targeted therapy side effects

Like any medication, targeted therapy can come with side effects. Most are manageable, but some can be serious or even life threatening. You can learn more about on our Targeted Therapy Side Effects page.