Real-world treatment patterns and clinical outcomes in patients with advanced or recurrent endometrial cancer re-challenged with platinum-based chemotherapy in Europe.

Objective: Although platinum re-challenge is a treatment option for patients with advanced/recurrent endometrial cancer, real-world outcomes for these patients in Europe are not well-documented. Thus, this study aimed to evaluate real-world treatment patterns and outcomes for platinum re-challenge in patients with advanced/recurrent endometrial cancer.

Methods: Endometrial Cancer Health Outcomes-Europe (ECHO-EU) is a multi-center, retrospective, medical record review conducted in France, Germany, Italy, Spain, and the United Kingdom, evaluating treatment patterns and outcomes. Patients with advanced/recurrent endometrial cancer treated with first-line systemic therapy and experiencing disease progression between July 2016 and June 2019 were eligible for inclusion in ECHO-EU. This analysis used data from a subset of patients, the platinum re-challenge cohort, who received platinum-based chemotherapy as second-line therapy after previous adjuvant/neoadjuvant and/or first-line platinum therapy. Kaplan-Meier analyses since initiation of second-line therapy estimated real-world progression-free survival and overall survival.

Results: Of the 475 ECHO-EU patients, 70 patients (15%) were platinum re-challenged and had a median age of 67 years (range; 44-81). The platinum-free interval (PFI) was <6 months for 27 patients (38.6%) and >6 months for 43 patients (61.4%). Complete or partial response to second-line therapy were achieved in 37.1% of patients, with similar overall response rates reported for patients with PFI <6 months (33.3%) and PFI ≥6 months (39.5%). The median (95% CI) overall survival from second-line therapy was 12 months (11-not estimable [NE]) overall and 14.1 (8.7-NE) and 12.0 (10.5-NE) months for patients with PFI <6 months and PFI >6 months, respectively. The median real-world progression-free survival from initiation of second-line therapy was 8.1 months (95% CI 7.6 to 10.0) overall and 7.6 (95% CI 5.3 to 19.8) and 8.5 (95% CI 7.9 to 12.0) months for patients with PFI <6 months and PFI ≥6 months, respectively.

Conclusion: Patients with advanced/recurrent endometrial cancer who were re-challenged with a platinum-based therapy had similar outcomes, irrespective of their PFI, indicating that further research is needed to assess the value of PFI in endometrial cancer. The findings also suggest an unmet medical need and scope for novel treatments that may improve the overall survival for these patients.