How immunotherapy is used to treat endometrial cancer

Immunotherapy refers to treating health conditions by changing how the immune system works. It includes therapies that boost the immune system’s ability to fight a disease (such as vaccines) as well as therapies that suppress the immune system (such as biologic therapies, which are used in the treatment of inflammatory disorders and autoimmune diseases).

In the treatment of cancers, immunotherapy refers to drugs and medical procedures that help the body’s immune system detect and destroy cancerous cells. It is used in the treatment of many different cancers that begin in many different locations within the body.

Immunotherapy is one of several treatment options that may be considered when treating endometrial cancer.

Understanding endometrial cancer

Endometrial cancer is a type of cancer that begins in the uterus. Also called the womb, the uterus is a female reproductive organ where a fetus develops during pregnancy. The uterus is lined with a layer of tissue called endometrium. This layer of tissue is where a fertilized egg will implant when a person becomes pregnant. The endometrium is also what is shed during menstruation.

Endometrial cancer begins when mutations in endometrial cells cause endometrial tissue to divide and multiply uncontrollably, forming tumors—and in cases of advanced endometrial cancer, spreading to nearby tissues and other areas of the body.

How is endometrial cancer treated?

Surgery, chemotherapy, radiation therapy, targeted therapy, and immunotherapy are all used in the treatment of endometrial cancer. In some cases, a combination of treatments may be used.

The choice of treatment will depend on the stage and grade of the cancer. It will also depend on the overall health of the person being treated, and that person’s preferences and priorities—for example, if the person is healthy enough for surgery and if preserving fertility is a priority of treatment.

Immunotherapy for endometrial cancer

The type of immunotherapy drugs that are used in the treatment of endometrial cancer are called PD-1 inhibitors. These drugs are typically used to treat advanced cancers that have specific genetic mutations that have not responded to other therapies.

PD-1 inhibitors are a type of immune checkpoint inhibitor. Here is a simplified explanation of how they work:

• Immune checkpoints are proteins that are found on the surface of immune cells. They act as a kind of brake, to stop immune cells from attacking healthy cells.
• Partner proteins are found on the surface of normal healthy cells. These bind with a checkpoint inhibitor to prevent an immune cell from attacking. Some cancer cells also have partner proteins, which help them avoid being attacked by the immune system, enabling the cancer cells to keep dividing and growing.
• Immune checkpoint inhibitors work by blocking immune checkpoints, which helps the immune system destroy and dispose of cancerous cells. This may help shrink tumors or slow the growth of a cancer.

PD-1 inhibitors act on a checkpoint inhibitor called PD-1, which is found on the surface of immune cells called T cells.

Like other cancer treatments, PD-1 inhibitors cause side effects.

Should you consider immunotherapy?

Your healthcare team will be your best source of information. Endometrial cancer is a different experience for every person, and every person living with endometrial cancer should work with a healthcare team to understand their diagnosis and their treatment options—including the potential benefits and risks of each treatment approach.

The future of immunotherapy

Medical researchers are still learning about immunotherapy and how it can be used in the treatment of endometrial cancer, and the role of immunotherapy in the treatment of endometrial cancer is expected to expand in the future. Research and clinical trials continue to look for new therapeutic targets, new approaches to therapy, and new ways to use existing therapies in combination with one another.