Case Reports in Oncology (Aug 2024)

De-Escalated Adjuvant Treatment for Advanced MMR Deficient Mixed Endometrioid/Clear Cell Endometrial Carcinoma with PD-1 Inhibition Alone: A Case Report

  • Danielle M. Blemur,
  • Ravali A. Reddy,
  • Susan M. Lang,
  • Malte Renz

DOI
https://doi.org/10.1159/000540357
Journal volume & issue
Vol. 17, no. 1
pp. 859 – 864

Abstract

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Introduction: Advanced mixed epithelial endometrial carcinomas are rare high-grade cancers with a poor prognosis. A clear cell component infers relative chemotherapy insensitivity, likely further increased by p53 wild type status and MMR deficiency. PD-1 inhibition for MMR deficient endometrial cancers has been recently added to first-line adjuvant treatment in combination with platinum-based chemotherapy. Information on de-escalation of adjuvant treatment to PD-1 inhibition alone without chemotherapy is sparse. Case Presentation: Here, we present a patient with advanced stage mixed epithelial endometrial carcinoma, a clear cell component and MMR deficiency who underwent de-escalated adjuvant treatment with PD-1 inhibition alone without simultaneous chemotherapy. Conclusion: Histotype-agnostic adjuvant monotherapy with checkpoint immune inhibitors alone appears to be a highly effective even in the rare mixed endometrial carcinomas if MMR protein deficient as described in this case report.

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