This review article!https://www.practicalradonc.org/article/S1879-8500(23)00176-5/fulltext
highlights that over a quarter of endometrial cancers are mismatch repair-deficient (dMMR), microsatellite instability-high (MSI-H). While this drives oncogenesis in the first place, it also renders them uniquely susceptible to immune checkpoint inhibition. So what role does radiation play for these dMMR, MSI-H locally-advanced cancers? After a summary of recent trials of ICI in this space, the authors conclude: “Based on the risk for local disease recurrence, sequential volume-directed radiation delivered concurrently during the pembrolizumab or dostarlimab maintenance phase can be considered. Since pembrolizumab and dostarlimab are given every 6 weeks in the maintenance phase, it may be reasonable to deliver radiation between the two cycles to reduce toxicity.” It’s best to see figure 1. | Hathout, Pract Radiat Oncol 2023
highlights that over a quarter of endometrial cancers are mismatch repair-deficient (dMMR), microsatellite instability-high (MSI-H). While this drives oncogenesis in the first place, it also renders them uniquely susceptible to immune checkpoint inhibition. So what role does radiation play for these dMMR, MSI-H locally-advanced cancers? After a summary of recent trials of ICI in this space, the authors conclude: “Based on the risk for local disease recurrence, sequential volume-directed radiation delivered concurrently during the pembrolizumab or dostarlimab maintenance phase can be considered. Since pembrolizumab and dostarlimab are given every 6 weeks in the maintenance phase, it may be reasonable to deliver radiation between the two cycles to reduce toxicity.” It’s best to see figure 1. | Hathout, Pract Radiat Oncol 2023