Dostarlimab治療晚期或復發性子宮內膜癌的檢視

The role of dostarlimab for treatment of advanced or recurrent endometrial cancer

Dostarlimab乃一PD-1，IgG4單株抗體，是一免疫檢測點抑制劑，可以阻止T細胞中PD-1與腫瘤細胞中PD-L1和PD-L2接受器的結合，促進T細胞活性，達到毒殺腫瘤細胞的功用。最近的臨床研究證明，以dostarlimab來治療含dMMR/MSI-H的子宮內膜癌十分有效，因此美國食品藥物管理局（FDA）和歐洲醫學會（EMA）在2021年均允許其合法使用。最近，第3期RUBY研究顯示，dostarlimab合併carboplatin、paclitaxel，再追加dostarlimab的治療效果，優於安慰劑合併carboplatin、paclitaxel，再追加安慰劑，在治療原發性晚期或復發性dMMR/MSI-H子宮內膜癌，結果病情和死亡率更低，表示dostarlimab為有效的治療藥物。

Dostarlimab is a PD-1(programmed death protein 1), IgG4 monoclonal antibody, which is an immune checkpoint inhibitor, interacts with adaptive immunity by binding to human PD-1, inhibiting PD-L1 (programmed deathligand 1) and PD-L2 receptors interaction, resulting in an increased T-cell activation. Recent clinical trials have shown that dostarlimab is effective in treating dMMR/MSI-H (mismatch repair deficiency/microsatellite instabilityhigh) in endometrial cancer patients, leading to its approval in the FDA (the Food and Drug Administration, Unit States) and EMA (European Medicine Agency, Europian Union) in 2021. The phase 3 RUBY study is to evaluate the efficacy and safety dostarlimab plus carboplatin-paclitaxel followed by dostarlimab versus placebo plus carboplatin-paclitaxel followed by placebo. The regimen contained dostarlimab group was associated with a significant lower risk of progression or death than the regimen without dostarlimab among patients with primary advanced or recurrent dMMR/MSI-H endometrial cancer.