In Primary Advanced or Recurrent Endometrial Cancer

Durable treatment options are needed, and dMMR/MSI-H biomarker testing can identify options for your patients1,2

Endometrial cancer has the second highest rate of death of gynecologic cancers in the US, and mortality is increasing3,4

For over 10 years, carboplatin + paclitaxel has been the standard of care for initial systemic treatment5

Test your endometrial cancer patients for their MMR/MSI status as recommended by NCCN Guidelines®6

dMMR/MSI-H are important biomarkers in endometrial cancer due to prognostic and predictive factors6

  • Tumors with dMMR are more likely to respond to anti–PD-1 therapies like JEMPERLI7,8
    • Increased mutations promote antitumor immune cell reaction and increased tumor-infiltrating lymphocytes7

~25-30% of endometrial tumors are dMMR/MSI-H; the highest rate across cancer types9-11

Use JEMPERLI in combination with CP for adults with dMMR/MSI-H primary advanced or recurrent endometrial cancer (EC) and as monotherapy for adults with dMMR advanced or recurrent EC that has progressed on or following treatment with a platinum-containing regimen.

CP=carboplatin-paclitaxel; dMMR=mismatch repair deficient; MSI-H=microsatellite instability high; NCCN=National Comprehensive Cancer Network; PD-1=programmed death receptor 1. 

Perform IHC testing using a validated and/or FDA-approved assay8

  • IHC is a reliable and accurate testing method to determine if a tumor is dMMR and identify patients who may benefit from immunotherapy for endometrial cancer2,7,8
  • There is an IHC-based, FDA-approved test that can confirm patient eligibility for JEMPERLI2,8
  • See the Mechanism of Action (MOA) for JEMPERLI

    The dMMR tumor cell journey 

    dMMR upregulates PD-1/PD-L112

    JEMPERLI is a PD-1–blocking antibody11

    • JEMPERLI binds to PD-1 to block interactions between PD-1 and PD-L1 or PD-L2
    • This releases the PD-1 pathway-mediated inhibition of the anti-tumor immune response to kill cancer cells*

    Blockade of the PD-1 receptor can restore T cell function13,14

    JEMPERLI mechanism of action

    *In mouse tumor models.2

    dMMR=mismatch repair deficient; PD-1=programmed death receptor-1; PD-L1=programmed death ligand 1; PD-L2=programmed death ligand 2.

    Inhibited T cell13,14

    • Cancer cells can increase expression of PD-L1 on their surface, which binds to PD-1 on T cells
    • This reduces the immune system's ability to identify and attack the cancer cells

    Activated T cell With JEMPERLI11,13,14

    • JEMPERLI binds to PD-1 receptors on the T cells, blocking PD-L1 or PD-L2 interactions
    • This enables T cells to identify and attack cancer cells by restoring cytotoxic activity in the T cell

    JEMPERLI harnesses the power of the immune system11

See Patient Types With dMMR/MSI-H Status Who May Benefit from JEMPERLI + CP

For dMMR/MSI-H primary advanced endometrial cancer, JEMPERLI + CP may help from the start2,15

Penny patient quote

*Not an actual patient. Based on patients treated in the RUBY trial.

  • Preoperative Diagnosis on Endometrial Biopsy Grade 3 endometrial cancer
  • Preoperative Imaging PET/CT consistent with pelvic node metastasis
  • Prior Interventions Minimal invasive total hysterectomy with bilateral salpingo-oophorectomy and surgical staging
  • FIGO Staging/Histology After Surgical Pathological Evaluation Stage IIIC1 carcinosarcoma
  • Biomarkers dMMR/MSI-H status confirmed following hysterectomy
  • Performance Status ECOG 1 at baseline
  • Initial Systemic Therapy Recommendation JEMPERLI (dostarlimab-gxly) + CP

For Your Appropriate Patients With dMMR/MSI-H Primary Advanced Endometrial Cancer

Start strong with the proven combination of JEMPERLI + CP2,15

Chart notes

  • Based on the RUBY trial, this case presents an opportunity to use JEMPERLI + CP2
  • Penny presented with aggressive carcinosarcoma at high risk of recurrence (>50% recurrence rate)16
  • Metastases beyond endometrium, to lymph nodes in the pelvis, indicate low potential for cure by radiation therapy or surgery alone15
  • dMMR/MSI-H status confirms appropriate eligibility for JEMPERLI + CP2

CP=carboplatin-paclitaxel; CT=computed tomography; ECOG=Eastern Cooperative Oncology Group; FIGO=International Federation of Gynecology and Obstetrics; PET=positron emission tomography.

JEMPERLI + CP may help when dMMR/MSI-H endometrial cancer comes back2

Rebecca patient quote

*Not an actual patient. Based on patients treated in the RUBY trial.

  • Preoperative Diagnosis on Endometrial BiopsyGrade 3 endometrioid cancer
  • Prior InterventionsTotal hysterectomy bilateral salpingo-oophorectomy and surgical staging (at initial diagnosis)
  • FIGO Staging/Histology After Surgical Pathological EvaluationStage II endometrial cancer, grade 3 endometrioid with lymphatic space involvement and outer third tumor spread
  • Adjuvant TreatmentCisplatin with external beam radiotherapy followed by carboplatin and paclitaxel
  • Follow-Up Imaging (7 Months Following Completion of Treatment)CT at 7 months confirmed recurrent disease with metastases to lung and liver indicating low potential for cure by surgery and/or radiation
  • BiomarkersMSI-H status confirmed at 7 months, following biopsy of recurrent tumor
  • Performance StatusECOG 1 at baseline
  • Systemic Therapy RecommendationJEMPERLI (dostarlimab-gxly) + CP

For Your Appropriate Patients With First Recurrent Endometrial Cancer

Consider the proven combination of JEMPERLI + CP2

Chart notes

  • Rebecca’s recurrence presents a specific challenge of how to treat aggressive disease after previous chemoradiation. Based on the patient population studied in the RUBY trial (including patients with recurrence ≥6 months after completing treatment [first recurrence]), the JEMPERLI combination may be appropriate in this case2
  • Rebecca initially presented with stage II disease and successfully completed treatment, but her cancer returned 7 months later2
  • CT confirmed recurrent disease with metastasis to lung and liver indicating low potential for cure by radiation therapy or surgery alone2
  • MSI-H status confirms appropriate eligibility for JEMPERLI + CP2
Line graph icon

See the RUBY trial results

Pie chart icon

See the GARNET trial results

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