PMID- 38164107
OWN - NLM
STAT- Publisher
LR  - 20240102
IS  - 1471-0528 (Electronic)
IS  - 1470-0328 (Linking)
DP  - 2024 Jan 2
TI  - Immune checkpoint inhibitors plus chemotherapy in first-line endometrial cancer 
      treatment: Still the era of microsatellites?
LID - 10.1111/1471-0528.17749 [doi]
AB  - OBJECTIVE: The combination of immune checkpoint inhibitors (ICIs) plus 
      chemotherapy is currently being tested as the first-line treatment of advanced 
      endometrial. We aimed to evaluate the efficacy and safety of this combination. 
      DESIGN: We performed a meta-analysis of randomized clinical trials. POPULATION 
      AND SETTING: Patients with advanced endometrial carcinoma receiving ICIs plus 
      chemotherapy in the experimental arm, compared with chemotherapy plus placebo in 
      the control arm, were included. METHODS AND OUTCOMES: We evaluated the 
      progression-free survival (PFS) as an efficacy outcome and the number and grades 
      of adverse events (AEs) for safety. Hazard ratios (HR) for PFS and risk ratios 
      (RR) for AEs, with 95% confidence intervals (CI), were calculated. RESULTS: 1303 
      patients were treated in the included studies. Adding ICIs to chemotherapy 
      significantly improved PFS in mismatch repair deficient (dMMR-HR 0.29; 95% CI, 
      0.20-0.42; p < 0.00001) and in mismatch repair proficient (pMMR-HR 0.64; 95% CI, 
      0.46-0.90; p = 0.01) patients. No difference emerged for all-grades AEs (RR 1.00; 
      p = 0.98), but the risk of >/=G3 AEs was increased in the ICIs + chemotherapy group 
      (RR 1.22; 95% CI, 1.11-1.34; p < 0.0001). CONCLUSIONS: Adding ICIs to 
      chemotherapy significantly improves PFS in first-line endometrial cancer, 
      regardless of MMR status.
CI  - (c) 2024 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology 
      published by John Wiley & Sons Ltd.
FAU - Maiorano, Mauro Francesco Pio
AU  - Maiorano MFP
AD  - Obstetrics and Gynaecology Unit, Department of Biomedical Sciences and Human 
      Oncology, University of Bari "Aldo Moro", Bari, Italy.
FAU - Messina, Carlo
AU  - Messina C
AD  - Oncology Unit, ARNAS Civico, Palermo, Italy.
FAU - Maiello, Evaristo
AU  - Maiello E
AD  - Oncology Unit, Casa Sollievo della Sofferenza IRCCS, San Giovanni Rotondo, Italy.
FAU - Cormio, Gennaro
AU  - Cormio G
AD  - Gynaecologic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, 
      Italy.
AD  - Department of Interdisciplinary Medicine (DIM), University of Bari, Bari, Italy.
FAU - Maiorano, Brigida Anna
AU  - Maiorano BA
AUID- ORCID: 0000-0001-5423-3158
AD  - Oncology Unit, Casa Sollievo della Sofferenza IRCCS, San Giovanni Rotondo, Italy.
LA  - eng
PT  - Journal Article
DEP - 20240102
PL  - England
TA  - BJOG
JT  - BJOG : an international journal of obstetrics and gynaecology
JID - 100935741
SB  - IM
EDAT- 2024/01/02 11:43
MHDA- 2024/01/02 11:43
CRDT- 2024/01/02 03:34
PHST- 2023/12/14 00:00 [revised]
PHST- 2023/09/19 00:00 [received]
PHST- 2023/12/19 00:00 [accepted]
PHST- 2024/01/02 11:43 [medline]
PHST- 2024/01/02 11:43 [pubmed]
PHST- 2024/01/02 03:34 [entrez]
AID - 10.1111/1471-0528.17749 [doi]
PST - aheadofprint
SO  - BJOG. 2024 Jan 2. doi: 10.1111/1471-0528.17749.