Mali Barbi, Medical Oncologist at Northwell Health, shared a post on X:
“My ASCO26 Endometrial Cancer recap PART 3. Saving the best for last.
This was the biggest disease area at the meeting. And it delivered.
The headline We have been telling dMMR advanced EC patients we can control their disease. After this week we need to update that conversation to cure.
RUBY at 4.5 years: mixture cure modeling estimates 54% of dMMR/MSI-H patients treated with dostarlimab + carbo/taxol may never recur. 14% with chemo alone. KM curve stopped moving. Only 4 new progression events in 2.5 additional years of follow-up. NRG-GY018 confirms it independently: 79% vs 60% alive at 48 months in dMMR, HR 0.56. pMMR median OS 44.4 vs 35.1 months. Both benefits held despite 93% and 81% IO crossover in the control arms respectively.
Two independent phase 3 trials. Same conclusion. The crossover argument is officially dead.
The pipeline PuxiSam (B7-H4 ADC): ORR 35-39% in post-platinum post-IO EC. FDA Breakthrough Designation granted. Phase 3 BLUESTAR-Endometrial01 now enrolling. Carcinosarcoma eligible.
Abemaciclib + hormonal therapy: phase 2 signal in recurrent EC. CDK4/6 inhibition in endometrial cancer is early but worth watching.
The bigger picture Endometrial cancer is the most common gynecologic malignancy in the US. It is also the one where outcomes have improved the most dramatically in five years. dMMR disease went from a poor prognosis subtype to a potentially curable one. pMMR still needs better solutions and the field knows it. My clinical take for tomorrow in clinic:
Every dMMR advanced EC patient starting frontline therapy gets dostarlimab + carbo/taxol. You can now tell them more than half of people in their situation may never recur. That is a different conversation than disease control. Have it.
For pMMR patients progressing after platinum and IO: ask whether B7-H4 testing is available at your institution and whether BLUESTAR-Endometrial01 is open at your site. Carcinosarcoma is eligible. This is the most important open EC trial right now for that population. The week is done. Endometrial cancer had a very good meeting in Chicago.”
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