Dostarlimab in dMMR Recurrent EC: Data From GARNET


Robert L. Coleman, MD, and Krishnansu S. Tewari, MD, reflect on data from the GARNET clinical trial of dostarlimab in dMMR recurrent endometrial carcinoma.


Robert L. Coleman, MD, FACOG, FACS:When pembrolizumab [Keytruda] came on the scene in endometrial [carcinoma], we got this indication. In the dMMR [mismatch repair–deficient], it was pan-tumor. It didn’t have an indication. It subsequently converted into an indication for endometrial cancer. Dostarlimab [Jemperli], another immune checkpoint inhibitor, was studied in a trial called GARNET. It turned out to be large study that had 2 cohorts. One was in the dMMR patient population, and 1 was in the pMMR [mismatch repair–proficient] population. [The trial] ended up having a large sample size. We’ve seen several reports of this, and ultimately the data from this trial also led to a disease-specific indication in endometrial cancer because of its outcomes.

It was very similar in its outcomes, very similar with the types of patients who were treated. Its objective response rate was north of 40%. The duration of response was also quite long. What is a little different in this trial is that if you look at the curves, there’s a bit of a sharper curve down to the 50% mark. The median progression-free survival in this trial is around 6 months as opposed to 12 with pembrolizumab. But that’s misleading because the 1- and 2-year progression rates are almost identical. It’s a very L-shaped curve. There may be a second population that’s very immune, sensitive, or responsive, and that was nicely demonstrated. The adverse events are very consistent in our experience. This is a much larger trial, but we saw what we expected to see in this study. We’re very nice with that.

Transcript edited for clarity.

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