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Post-hoc survival outcomes based on initial and subsequent treatment in patients with mmrp/MSS primary advanced or recurrent endometrial cancer in the ENGOT-EN6-NSGO/GOG-3031/RUBY trial
Abstract   Peer reviewed

Post-hoc survival outcomes based on initial and subsequent treatment in patients with mmrp/MSS primary advanced or recurrent endometrial cancer in the ENGOT-EN6-NSGO/GOG-3031/RUBY trial

Dominik Denschlag, Matthew A. Powell, Henrik Roed, Lucy Gilbert, Oleksandr Zub, Carolyn Mccourt, Evelyn Fleming, Roberto Angioli, Noelle Cloven, Kathryn Pennington, …
International journal of gynecological cancer, Vol.36(2 Supplement 1), 104434
02/2026
DOI: 10.1016/j.ijgc.2025.104434

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Abstract

Introduction/Background Dostarlimab+carboplatin-paclitaxel (CP) is the only immunotherapy+chemotherapy (CT) combination to report significant OS benefits in patients with primary advanced or recurrent endometrial cancer (pA/R EC) as shown in Part 1 of the phase 3 RUBY trial (NCT03981796). With global approvals for this frontline regimen, outcomes with subsequent treatments post-immunotherapy are of interest, particularly in patients with mismatch repair-proficient/microsatellite stable (MMRp/MSS) pA/R EC. We present post-hoc analyses of outcomes based on first follow-up anticancer therapies (FUACTs) in RUBY Part 1. Methodology Patients were randomised 1:1 to receive dostarlimab+CP or placebo+CP Q3W (6 cycles) followed by dostarlimab/placebo monotherapy Q6W for ≤3 years. At 22Sep2023 data cutoff, efficacy analyses were conducted for patients in the MMRp/MSS population who received either pembrolizumab+lenvatinib (pem/len; most common immunotherapy) or CT (most common FUACT) as FUACT. Results 376 patients were enrolled with MMRp/MSS pA/R EC. At data cutoff, fewer patients receiving dostarlimab+CP (53.6%; 103/192) had progressed versus placebo+CP (72.3%; 133/184). In patients receiving FUACT, irrespective of progression, first FUACT of pem/len or CT were received by 18/105 (17.1%) and 48/105 patients (45.7%), respectively, in the dostarlimab+CP arm and 27/134 (20.1%) and 48/134 patients (35.8%), respectively, in the placebo+CP arm. Numerically longer median OS was seen in patients receiving dostarlimab+CP versus placebo+CP regardless of first FUACT evaluated in these analyses (Table). Patients in the dostarlimab+CP arm who received first FUACT of CT had more favourable survival outcomes than those in the placebo+CP arm who received first FUACT of CT or patients who received first FUACT of pem/len. Conclusion In the difficult-to-treat MMRp/MSS population, among patients who received pem/len or CT as first FUACT, OS favoured patients receiving initial systemic therapy with dostarlimab+CP versus placebo+CP. These findings support that dostarlimab+CP as frontline treatment provides optimal survival outcomes regardless of subsequent treatment and further reinforce dostarlimab+CP as standard of care for patients with pA/R EC.

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