A new treatment for womb cancer

Treatment for womb cancer occupational health news

A new drug therapy for womb cancer

Womb cancer affects just under 10,000 women in the UK every year. It is the 4th most common cancer affecting women in the UK. It is sometimes called uterine cancer or endometrial cancer.

Survival rates for womb cancer are usually very good and, if the cancer is found early (at Stage 1) 90% of women who have the cancer will survive for five years or more. Surgery is usually the main treatment for womb cancer and it is often highly effective. Most of those who survive for five years will have been cured.

Sadly, especially if the condition is diagnosed later (at Stage 4), then many fewer women will survive and only 15% are likely to survive for 5 years or more. Surgery does not work for every patient and radiotherapy and chemotherapy are also commonly used to treat patients too.

Although platinum is more commonly associated with jewellery, platinum compounds are used widely as chemotherapy.
Platinum-based chemotherapy is used to treat many different cancers, because the compound destroys rapidly multiplying cells, like cancer cells.

There is no clear agreement amongst doctors about which treatment should be used as standard, if platinum-based chemotherapy fails, when treating womb cancer.

Combination drug therapy

Results published in January in the New England Journal of Medicine show that a combination of two existing drugs offers improved survival rates for many women. The study first began in 2018 and is scheduled to complete in 2023.

Researchers have shown that patients with advanced endometrial (womb) cancer treated with Lenvatinib plus Pembrolizumab
had significantly longer progression-free survival rates than chemotherapy alone.

Made by Eisai, Lenvatinib is a ‘small molecule’ anti-cancer drug that inhibits the growth of tumours by inhibiting growth factors in tumours. It is a relatively new drug, first licensed in 2015. It is commonly used to treat thyroid cancers, liver cancers and kidney cancers.

Pembrolizumab (commonly known as Keytruda) is a very widely used monoclonal antibody treatment (an immunotherapy) manufactured by Merck. It was first licensed in 2014 and in 2017 regulators extended its use to treat any cancer that could not be operated upon by surgeons.

About the study

In the Phase 3 study, 827 patients with advanced endometrial cancer, who had previously been treated with platinum-based chemotherapy, were randomly assigned to two groups.

Patients were recruited to the trial worldwide, predominantly in the USA, Europe, Japan, Russia, the UK, Argentina and Brazil.

The first group (411 patients) was treated with a daily Lenvatinib tablet and with intravenous Pembrolizumab every three weeks. The second group (416 patients) was treated more traditional chemotherapy; Doxorubicin (first licensed in 1974) or Paclitaxel (first licensed in 1993).

The trial aimed to assess progression-free survival rates and the safety of the drug therapies as a combined treatment.

The effect on survival

Progression-free survival is the term used to describe whether the cancer continues to develop or not after treatment. Average progression-free survival was almost doubled amongst those treated with the combination therapy, compared to those treated with traditional chemotherapy, from nearly 4 months to nearly 7 months.

The average overall survival time was much longer for those treated with Lenvatinib plus Pembrolizumab, compared to the traditional approach. Survival was extended from 12 months to nearly 18 months.

However, the safety profile of the combination therapy was worse, with 89% of the patients experiencing adverse events, compared to 73% of those who received chemotherapy.

When will the treatments be available?

The study still has another year to run before it is completed and, although the data so far is positive, it is possible that the remainder of the trial period could change the results.

If the trial continues to show improved survival times, it is likely to take regulators some months to approve the combined therapy for use too, which is also not a foregone conclusion.

Conservatively, it is likely to be mid-2024 before the treatments are likely to enter mainstream usage. The hope is that progression-free survival times can continue to be extended more as the trial continues.



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