Treatment patterns and outcomes by mismatch repair/microsatellite instability status among patients with primary advanced or recurrent endometrial cancer in the United States.

IF 3 4区医学 Q2 ONCOLOGY

Future oncology Pub Date : 2025-06-11 DOI:10.1080/14796694.2025.2516891

Dana M Chase, Monica Kobayashi, Pratyk Gomez, Solomon J Lubinga, John K Chan

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Abstract

Aims: To describe real-world patient characteristics, treatment patterns, and clinical outcomes in primary advanced/recurrent endometrial cancer (pA/R EC) by mismatch repair/microsatellite instability (MMR/MSI) status who initiated first-line therapy.

Materials & methods: Data from the Flatiron Health electronic health record-derived database were analyzed from patients with a diagnosis of pA/R EC who started treatment between 1 January 2013, and 31 August 2022, from ≈ 280 US clinics. MMR/MSI status and treatment patterns were summarized; time to next treatment (TTNT) and overall survival (OS) were estimated using Kaplan-Meier methods.

Results: Of 2022 patients, 11.03%, 27.79%, and 61.18% had MMR-deficient/MSI-high (dMMR/MSI-H), MMR-proficient/microsatellite stable (MMRp/MSS), and unknown MMR/MSI status, respectively. Platinum-based chemotherapy combinations, including carboplatin-paclitaxel, were the most frequent first-line regimens (dMMR/MSI-H, 49.33%; MMRp/MSS, 55.52%; unknown, 65.08%); treatment patterns differed between subgroups. Median TTNT with platinum-based combinations were 6.87, 8.08, and 7.85 months, respectively; OS medians were 41.89, 26.18, and 21.62 months, respectively.

Conclusions: Platinum-based chemotherapy combinations, the recommended first-line treatment, were not used in ≈ 40% of patients. TTNT rates were similar to the PFS rates in the carboplatin-paclitaxel arms in the RUBY and GY-018 trials; OS rates were similar to RUBY, highlighting the potential for combination therapies to improve outcomes.

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美国原发性晚期或复发子宫内膜癌患者的错配修复/微卫星不稳定状态的治疗模式和结果

目的：描述现实世界中因错配修复/微卫星不稳定（MMR/MSI）状态而开始一线治疗的原发性晚期/复发性子宫内膜癌（pA/R EC）患者的特征、治疗模式和临床结果。材料与方法：分析来自Flatiron Health电子健康记录衍生数据库的数据，这些数据来自2013年1月1日至2022年8月31日期间开始治疗的pA/R EC患者，来自约280个美国诊所。总结MMR/MSI现状及治疗模式；采用Kaplan-Meier法估计下一次治疗时间（TTNT）和总生存期（OS）。结果：在2022例患者中，分别有11.03%、27.79%和61.18%的患者存在MMR缺陷/MSI高（dMMR/MSI- h）、MMR熟练/微卫星稳定（MMRp/MSS）和未知MMR/MSI状态。以铂为基础的化疗组合，包括卡铂-紫杉醇，是最常见的一线方案(dMMR/MSI-H, 49.33%；MMRp /海量存储系统(MSS)中,55.52%;未知,65.08%);治疗模式在亚组之间有所不同。铂基联合用药的中位TTNT分别为6.87、8.08和7.85个月；OS中位数分别为41.89、26.18和21.62个月。结论：约40%的患者未使用推荐的一线治疗方案铂类联合化疗。在RUBY和GY-018试验中，卡铂-紫杉醇组的TTNT率与PFS率相似；OS率与RUBY相似，突出了联合治疗改善预后的潜力。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Future oncology ONCOLOGY-

CiteScore

5.40

自引率

3.00%

发文量

335

审稿时长

4-8 weeks

期刊介绍： Future Oncology (ISSN 1479-6694) provides a forum for a new era of cancer care. The journal focuses on the most important advances and highlights their relevance in the clinical setting. Furthermore, Future Oncology delivers essential information in concise, at-a-glance article formats - vital in delivering information to an increasingly time-constrained community. The journal takes a forward-looking stance toward the scientific and clinical issues, together with the economic and policy issues that confront us in this new era of cancer care. The journal includes literature awareness such as the latest developments in radiotherapy and immunotherapy, concise commentary and analysis, and full review articles all of which provide key findings, translational to the clinical setting.