Exciting New Combination Therapy Gives Hope To Women With Advanced Endometrial Cancer

“However, there’s a population of patients that are diagnosed at a later stage, stage three or four, or that have their cancer come back after initial therapy. And those patients have had a really hard time,” she adds.

According to Westin, the latest treatments combine immunotherapy with standard chemotherapy plus a drug that prevents cancer cells from fixing their own DNA.

The results are encouraging, especially for patients who have late-stage endometrial cancer or their disease has come back.

Related: Immunotherapy, PARP Inhibitor Drug Combination Shows Promise for Endometrial Cancer

How does the treatment work?

The new combo involves two drugs:

• Durvalumab (brand name IMFINZI): As an immunotherapy drug, it powers up the body’s immune system so it can better identify and attack cancer cells. Doctors often use durvalumab alongside chemotherapy.
• Olaparib (brand name LYNPARZA): This PARP inhibitor, a type of drug that helps treat some cancers by blocking an enzyme called PARP that helps repair damaged DNA in cells. Olaparib destroys cancer cells, especially cells that already have trouble repairing their DNA. It is often, but not always, used as an add-on to durvalumab.

The combo treatment hits cancer with a double whammy by boosting the body’s immune response against cancer cells while also disrupting the cancer’s DNA repair mechanisms.

“The combination of durvalumab and chemotherapy, with or without olaparib, could redefine the standard care for advanced endometrial cancer, providing new hope for patients who previously had limited options,” Dr. Westin explains.

What does the evidence show?

Westin is a scientific investigator on the phase 3 DUO-E trial, a large clinical study that compares different treatments for patients with newly diagnosed advanced or recurrent endometrial cancer.

The main goal of the trial is to see which treatment can delay or prevent the cancer from getting worse or spreading. It also looked at overall survival, quality of life, and safety.

The study is ongoing, but some promising results were published last year.

• Patients treated with chemotherapy and durvalumab, then durvalumab alone, had a 29% lower risk of cancer progression or death than those receiving chemotherapy and a placebo.
• Patients given chemotherapy and durvalumab, then both durvalumab and olaparib, saw a 45% reduced risk of cancer worsening or death compared to those with chemotherapy and a placebo.
• Durvalumab plus olaparib may be more effective for patients with specific tumor characteristics.

“Reducing your chance of recurrence by half is a huge potential benefit,” Westin notes.

Related: Understanding the Risks and Symptoms of Uterine Cancer

What are the side effects?

Like all cancer treatments, these therapies can also have side effects. The decision to use these treatments involves weighing the potential benefits against the risks and side effects, tailored to each patient’s situation and health condition.

Durvalumab can cause inflammation in various parts of the body, which can lead to:

• Skin rashes
• Diarrhea
• Liver inflammation.

Olaparib may lead to side effects such as:

• Fatigue
• Nausea
• Blood-related issues such as anemia
• Increased risk of developing certain other cancers due to the DNA repair inhibition.

To manage these side effects, your doctor will closely monitor you and may adjust your treatment plan or prescribe medications to manage specific side effects.

One other thing to keep in mind about this combination treatment: it may add to your cost of care. Discuss treatment expenses with your care team. They can help you understand your insurance coverage, out-of-pocket costs, and potential financial assistance programs.

How is this approach changing treatment?

Immunotherapy and PARP inhibitors are reshaping cancer care by offering new hope where traditional treatments fall short.

These therapies focus not just on attacking cancer broadly but on finding and attacking the cancer’s specific weaknesses.

Immunotherapies like durvalumab, train the immune system to spot and destroy cancer cells more efficiently. PARP inhibitors like olaparib target the cancer cells’ ability to repair their DNA, leading to their destruction.

Dr. Westin emphasizes the significance of this shift.

“We’re not just treating cancer, we’re outsmarting it by targeting its vulnerabilities. This approach marks a significant departure from one-size-fits-all treatments, offering a beacon of hope for those with advanced stages of endometrial cancer,” she says.

Watch: Nobel Prize Winner, Dr. Jim Allison discusses breakthrough cancer treatment, immunotherapy

Questions for your doctor

• Is this new treatment a good choice for me?
• What improvements can I expect, and how will we track progress?
• What side effects can I expect, and how can we deal with them?
• How will these treatments affect my daily routine and well-being?
• What is the cost, and is there financial assistance available?

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