New drug offers hope for woman with incurable womb cancer, after NHS watchdog approves the life-extending treatment

Thousands of women with incurable uterine cancer now have access to a drug that extends survival in more than two-thirds of cases – a move heralded as a crucial advance in treatment.

The drug, called dostarlimab, was given the green light last year for women who had previously undergone treatment, but now the Medicines and Healthcare products Regulatory Agency has approved it as a first-line treatment.

Studies show that dostarlimab combined with chemotherapy keeps the disease at bay for at least two years in 71 percent of patients with a genetic, incurable form of uterine cancer, compared to just 15 percent who received chemotherapy alone.

Every year around 9,000 British women are diagnosed with the disease, also known as endometrial cancer. It mostly affects those who have gone through menopause, but obesity and excessive estrogen levels due to hormone replacement therapy also increase the likelihood of developing it.

Approximately 9,000 women per year are diagnosed with endometrial cancer

About 71 percent of women treated with dostarlimab kept their cancer at bay for two years, compared to just 15 percent of those who underwent chemotherapy alone

The first symptom is usually abnormal vaginal bleeding. This could be bleeding that occurs after menopause, an unusually heavy period, or bleeding between periods.

Patients may also experience vaginal discharge that is either pink or dark in color. Due to the pronounced symptoms, endometrial cancer is often detected early and is curable in most cases.

However, if these symptoms are missed, endometrial cancer can spread to surrounding organs – often the intestines and bladder – and then become difficult to treat.

Only 15 percent of women with advanced endometrial cancer survive their cancer for five years or longer.

Dostarlimab made headlines in June last year after a small US study showed that tumors “disappeared” in 18 colon cancer patients treated with it. The participants had tumors with a specific genetic trait that affects about one in ten colorectal cancer patients, but it is far more common in endometrial cancer, affecting one in three people.

The drug is now available to all patients with this form of the disease when the cancer has spread to other parts of the body.

The expert in gynecological cancer, Dr. Susana Banerjee, says there is now “a new standard of care” for women with the disease.

“We hope that over time we will see that the drug also improves overall survival, meaning that patients who receive this treatment live longer,” she adds. “We are very excited about the future of women with uterine cancer and hope to ultimately find a cure.”

Most patients must first undergo surgery to remove the tumor, as well as chemotherapy and/or radiation therapy to kill additional cancer cells.

This is very effective in patients diagnosed at an early stage.

However, in about a fifth of cases, the disease is transmitted when it has spread outside the uterine lining. In another fifth of patients, the cancer recurs within two years of treatment.

Dostarlimab works by binding to a protein called PD-1 and blocking its signals that cause cancer cells to multiply. Without PD-1, cancer cells are “unmasked” to the immune system and can be destroyed.

Dostarlimab is given via a 30-minute drip every three weeks. It works best in patients with a genetic error called mismatch repair deficiency, which makes carriers susceptible to colon, uterine and other cancers.

The most common side effects caused by the drug were hypothyroidism, skin rashes, dry skin, fever and increased liver enzyme levels in the blood.

“We hope that more women will now live longer, have a better quality of life and have more time with family and friends,” says Dr. Banerjee.