The combination of avelumab and axitinib may be effective in patients with mismatch repair–proficient recurrent or persistent endometrial cancer, according to new findings presented by Lee et al at the Society of Gynecologic Oncology’s (SGO) 2024 Annual Meeting on Women’s Cancer.
Background
Avelumab is an immune checkpoint inhibitor capable of exposing tumor cells to an immune system attack, whereas axitinib was designed to block the growth of blood vessels in tumors and inhibit the progression of tumor cells. The drugs have been approved as a first-line therapy in advanced renal cell carcinoma.
Prior research has shown that the proteins hypoxia-inducible factor 1 alpha and vascular endothelial growth factor (VEGF), which help tumors develop their own blood vessels, may also help them remain undetectable to the body’s immune system. In mismatch repair–proficient endometrial cancer, tumor cells are able to detect and correct errors in their DNA.
Study Methods and Results
In the new clinical trial, researchers assigned 35 patients with mismatch repair–proficient recurrent or persistent endometrial cancer who had received at least one prior regimen of chemotherapy to receive avelumab plus axitinib.
The researchers found that 40% (n = 14) of the patients achieved a response to therapy and 5.7% (n = 2) achieved a complete response. They noted that responses were observed in patients across all subtypes of endometrial cancer—including carcinosarcoma, clear cell, endometrioid, and serous—as well as molecular subtypes. The median progression-free survival was 7 months, and 6 months following receipt of therapy, 40% (n = 14) of the patients experienced progression-free survival.
Conclusions
The researchers revealed that an earlier combination of a VEGF-blocking drug, lenvatinib, and an immune checkpoint inhibitor, pembrolizumab, was active in endometrial cancer. However, they concluded that avelumab and axitinib could be more effective and potentially less toxic than lenvantinib and pembrolizumab in patients with mismatch repair–proficient recurrent or persistent endometrial cancer.
