Therapeutic Sequencing and NCCN Guidelines in Endometrial Cancer

In this episode, ‘Therapeutic Sequencing and NCCN Guidelines in Endometrial Cancer,’ the expert Oncology Pharmacists explored the following questions:

What are some other drug classes we use to treat endometrial cancer, and where are they placed in our algorithm?

Looking at our National Comprehensive Cancer Network (NCCN) guidelines where they currently stand, what are the recommendations for tumors with mismatch repair deficient (dMMR) and microsatellite instability-high (MSI-H)?

The panelists examined the broadening treatment landscape beyond PD-1 inhibitors, highlighting the significant role of trastuzumab in human epidermal growth receptor 2 (HER2)–overexpressing uterine serous and carcinosarcoma subtypes. The panelists discussed the integration of targeted therapies like trastuzumab deruxtecan (T-DXd) and tyrosine kinase inhibitors (TKIs) such as lenvatinib, while also touching on the potential for hormonal therapies and antibody-drug conjugates (ADCs) in specific populations. The experts provided a detailed review of NCCN Guideline recommendations, noting that pembrolizumab, dostarlimab, and durvalumab plus chemotherapy are Category 1 options for dMMR patients. They also discussed the nuances of the DUO-E trial and the LEAP-001 trial in shaping first-line and maintenance strategies for proficient mismatch repair (pMMR) populations.

Throughout the conversation, the experts provided a comprehensive reflection on the field and the factors that may shape how clinicians approach care moving forward.

The next episode in this series, ‘Navigating Institutional Barriers: Inventory Management and EHR Pathways in Endometrial Cancer,’ features the panelists advancing their conversation on endometrial cancer and focusing on inventory management, the transition to subcutaneous formulations, and the role of the pharmacist in navigating electronic health records.