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Fast-growing uterine cancer may respond better to immunotherapy, USA Health study says

Research completed at the USA Health Mitchell Cancer Institute suggests that aggressive uterine cancer may respond better to immunotherapy than slower growing types.

Published Mar 4th, 2020

By Carol McPhail

CMcPhail@health.southalabama.edu

Research completed at the USA Health Mitchell Cancer Institute suggests that aggressive uterine cancer may respond better to immunotherapy than slower growing types. This research was recently published online in the international journal Gynecologic Oncology.

The study, led by Nathaniel Jones, M.D., a gynecologic oncologist at the USA Health Mitchell Cancer Institute, suggests that women with “high-grade” cancer of the uterus -- cancer that is significantly abnormal in appearance and often fast growing -- may benefit from therapy that helps the body’s own immune system to recognize and fight cancer cells.

Cancer of the endometrium, or lining of the uterus, is the fourth most common cause of cancer among women and the most common gynecologic cancer. Immunotherapy has been shown to be effective against certain cancers, including melanoma, lung and bladder cancers. It tends to produce fewer side effects in patients than traditional chemotherapy.

“When women recur with uterine cancer, many times our treatment options are limited,” said Jones, who holds a faculty position of assistant professor of oncologic sciences at the Mitchell Cancer Institute. “The good news is that most women with uterine cancer have an excellent prognosis and are cured with their initial treatment. However, women with aggressive high-grade tumors often time recur, and our research aims to expand and improve the treatments available.”

Jones said the researchers sought to identify biomarkers that could help physicians predict which uterine cancer patients may benefit from immunotherapy. “That’s the hot topic -- trying to find a biomarker that is a predictor of response,” Jones said.

The study involved more than 600 samples from cancer patients. Researchers used a molecular database to analyze tumors that ranged from low grade (with the best prognosis) to high grade (with the worst prognosis). They found that high-grade tumors had elevated levels of three biomarkers -- programmed death ligand 1 (PD-L1), tumor mutation burden (TMB) and microsatellite instability (MSI), indicating that these could be targets for immunotherapy. “Initially, we found that higher grade tumors have more immunogenic markers,” Jones said. “Hopefully, this new information provides us with additional treatment options for women who have a poorer prognosis.”

Jones said that further research is under way.

One current clinical trial available at the Mitchell Cancer Institute is enrolling patients with metastatic endometrial cancer in order to compare responses to immunotherapy with responses to traditional chemotherapy, he said.

In addition, researchers hope to explore whether black women have a similar response to white women when treated with immunotherapy. “We know that there is a disparity in outcomes with traditional treatment approaches,” Jones said. “In order to answer that question, we need to ensure that clinical trial enrollment is representative of the patient population we treat. Increasing black participation is one of the fundamental components of our clinical trial research efforts.”

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