New Drug Offers Hope for Women With Incurable Womb Cancer, After NHS Approves Life-Extending Treatment
By Eve Simmons | Published: 22:00 BST, 14 October 2023 | Updated: 22:51 BST, 14 October 2023
Approximately 9,000 British women are diagnosed with endometrial cancer, also known as womb cancer, each year. A significant breakthrough in treatment has been made with the approval of a drug called dostarlimab. Initially given the green light last year for women who have undergone previous treatment, dostarlimab has now been approved as a first-line treatment by the Medicines and Healthcare Products Regulatory Agency.
Studies show that when combined with chemotherapy, dostarlimab keeps the disease at bay for at least two years in 71% of patients with a genetic, incurable type of womb cancer. This is in comparison to just 15% of patients given chemotherapy alone. The availability of this drug marks a significant step forward in the treatment of womb cancer, offering hope and extended survival time for thousands of women.
Womb cancer primarily affects women who have reached menopause, although obesity and excessive estrogen caused by hormone replacement therapy (HRT) can also increase the risk. The most common initial symptom is abnormal vaginal bleeding, which may occur after menopause, during unusually heavy periods, or between periods. Endometrial cancer is often detected early due to its distinctive symptoms, which allows for a higher chance of successful treatment.
However, if the symptoms are missed or ignored, the cancer can spread to nearby organs such as the bowel and bladder, making it more challenging to treat. Unfortunately, only 15% of women with advanced endometrial cancer will survive for five years or more.
Last year, dostarlimab gained attention after a small US trial showed promising results in treating bowel cancer. Tumours vanished in 18 patients with a specific genetic characteristic, and it is more prevalent in endometrial cancer, affecting one in three individuals. The drug will now be accessible to all patients with this form of the disease if it has spread to other parts of the body.
Gynaecological cancer expert Dr. Susana Banerjee emphasizes that dostarlimab represents a new standard of care for women with endometrial cancer. She also hopes that the drug will improve overall survival rates, offering a potential cure. Typically, patients will undergo surgery to remove the tumour, followed by chemotherapy and/or radiotherapy to eliminate remaining cancer cells. While effective for early-stage diagnosis, about a fifth of cases are caught when the cancer has spread beyond the womb lining, and another fifth experience recurrence within two years of treatment.
Dostarlimab functions by binding to a protein known as PD-1 and preventing its signals that promote the multiplication of cancer cells. Without PD-1, cancer cells become exposed to the immune system and can be destroyed. The drug is administered every three weeks via a 30-minute drip. It is most effective in patients with a genetic fault called mismatch repair deficiency, which predisposes individuals to bowel, womb, and other types of cancer.
Common side effects of dostarlimab include underactive thyroid glands, skin rashes, dry skin, fever, and increased liver enzyme levels in the blood. Dr. Banerjee expresses hope that this drug will provide women with improved longevity, quality of life, and more time with loved ones.
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