Addition of immunotherapy shows survival benefit in follow-up trial for advanced or recurrent endometrial cancer
Previously, immature overall survival results of the NRG Oncology GY018 (NRG-GY018) trial suggested that the use of the immunotherapy drug pembrolizumab in combination with chemotherapy improved overall survival for patients with advanced stage or recurrent endometrial cancer when compared to chemotherapy alone. Notably, this benefit was observed in both the mismatch repair proficient (pMMR) and mismatch repair deficient (dMMR) populations.
An analysis of the study data, with prolonged follow-up, demonstrated that there was a sustained numerical benefit in overall survival for patients who received pembrolizumab with chemotherapy even when a large proportion of the initial placebo-treated patients received post-protocol immunotherapy.
These results were presented during the Gynecologic Oncology Session at the 2026 American Society of Clinical Oncology (ASCO) Annual Meeting. The findings were also published in the journal Nature Medicine.
"These findings are particularly important because they address a long-standing gap in the treatment of advanced and recurrent endometrial cancer which historically has been plagued by poor outcomes and limited therapeutic progress," stated Ramez N. Eskander, MD, of the University of California, San Diego and the lead author of the NRG-GY018 abstract.
"The fact that the survival advantage persisted in the dMMR and pMMR EC populations, adds great confidence to the use of pembrolizumab in combination with chemotherapy in treatment of appropriately selected patients, irrespective of MMR status.
"In the pMMR EC cohort, the persistent non-statistically significant but notable benefit in overall survival, despite substantial poststudy immunotherapy utilization, may suggest that early incorporation of this regimen provides the greatest clinical benefit."
Despite the change in treatment for the patients on the reference arm of this study, patients that initially received pembrolizumab and chemotherapy on the experimental arm among the pMMR group still experienced a 9.3-month median overall survival benefit in the prolonged follow-up analysis.
Patients on NRG-GY018 (809) were randomly assigned to receive either pembrolizumab or placebo with carboplatin and paclitaxel chemotherapy. Overall survival analysis data were cut off on April 14, 2026, with information fractions of 43% and 82% in the dMMR and pMMR EC cohorts, respectively.
In the prolonged follow-up, the addition of pembrolizumab resulted in a sustained overall survival benefit in the dMMR endometrial cancer cohort. At 48 months, 79% of the dMMR patients treated with pembrolizumab were alive versus 60% of the patients treated with placebo, HR 0.56 (95% CI 0.34 to 0.92).
This benefit continued despite at least 93% of dMMR endometrial cancer patients in the control arm, who received subsequent treatment, receiving poststudy immunotherapy. In the pMMR population, the median overall survival was 44.4 months versus 35.1 months for the patients receiving placebo.
Again, the survival benefit continued despite at least 81% of pMMR endometrial cancer patients in the control arm receiving poststudy immunotherapy.
This article was originally published on MedicalXpress Breaking News-and-Events.