Obstetrics & Gynaecology · Endometrial Carcinoma

In the management of advanced or recurrent endometrial carcinoma with dMMR/MSI-H status, the landmark GARNET trial demonstrated activity of which agent as a single agent?

  • A Pembrolizumab (anti-PD-1)
  • B Nivolumab (anti-PD-1) plus ipilimumab
  • C Lenvatinib plus pembrolizumab combination
  • D Dostarlimab (anti-PD-1)
Correct answer: D. Dostarlimab (anti-PD-1)

Explanation

The GARNET trial evaluated dostarlimab (anti-PD-1 antibody, TSR-042) as monotherapy in advanced/recurrent endometrial cancer. In the dMMR/MSI-H cohort, overall response rate was ~42% with durable responses (median duration not reached at data cutoff). This led to FDA approval of dostarlimab for dMMR endometrial cancer after prior platinum-based therapy. The KEYNOTE-158 trial similarly showed pembrolizumab activity in MSI-H solid tumors. Lenvatinib + pembrolizumab (from KEYNOTE-775) is used for pMMR endometrial cancer regardless of MSI status. The DUO-E and NRG/GOG study established combination immunotherapy plus platinum in first-line advanced disease. dMMR testing is now standard for all advanced/recurrent endometrial cancers.

Reference: Shaw's Textbook of Gynaecology, 17th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.

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