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Endometrial Cancer — SCE Medical Oncology MCQ

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ModerateGynaecological CancersEndometrial CancerSCE Medical Oncology

A 50-year-old woman with endometrial cancer molecular classification showing dMMR/MSI-H status is being planned for first-line treatment. In the context of the RUBY trial, what was the primary finding?

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Correct answer: A — Dostarlimab added to carboplatin-paclitaxel improved PFS in all-comers, with the most dramatic benefit in dMMR/MSI-H subgroup

The RUBY trial (Mirza et al NEJM 2023) demonstrated that adding dostarlimab (anti-PD-1) to carboplatin-paclitaxel significantly improved PFS in advanced/recurrent endometrial cancer, with a dramatic PFS benefit in the dMMR/MSI-H subgroup (HR 0.28). The benefit was also seen (to a lesser degree) in the pMMR population. NICE approved dostarlimab + chemotherapy for this indication. This, alongside NRG-GY018 (pembrolizumab), established ICI-chemotherapy as first-line standard.

Reference: ESMO 2024 Endometrial Cancer Guidelines; RUBY Mirza et al NEJM 2023; NICE dostarlimab approval