Aims: In Part 1 of the phase 3 ENGOT-EN6-NSGO/GOG-3031/RUBY trial (NCT03981796; funding: GSK), dostarlimab+carboplatin-paclitaxel (CP) significantly improved PFS (HR 0.64) and OS (HR 0.69) vs placebo+CP in the overall population of patients with pA/rEC. Limited data are available on outcomes with follow-up anticancer treatment (FUACT) after dostarlimab+CP. Here we report post-progression survival outcomes of patients in the overall and mismatch repair proficient/microsatellite stable (MMRp/MSS) populations who received FUACT of immunotherapy (IO).
Methods: Patients were randomized 1:1 to receive dostarlimab/placebo+CP Q3W (6 cycles) followed by dostarlimab/placebo monotherapy Q6W for ≤3 years. At interim analysis 2 (37.2 mo of follow-up), updated post hoc analyses of OS adjusted for treatment switching via rank-preserving structural failure time (RPSFT) were performed in the overall and MMRp/MSS populations of pts who received FUACT of IO and for patients receiving pembrolizumab-lenvatinib (PEM-LEN) in the MMRp/MSS population.
Results: In total, 494 patients were randomized. FUACT of IO was received by 137 and 102 patients in the overall and MMRp/MSS populations, respectively; PEM-LEN was received by 65 patients in the MMRp/MSS population.
Approximately twice as many patients received FUACT of IO in the placebo+CP versus dostarlimab+CP arm. When adjusted for subsequent IO, RPSFT analyses showed HRs of 0.63 (overall) and 0.76 (MMRp/MSS) for dostarlimab+CP vs placebo+CP, consistent with the unadjusted HRs for OS in the primary analysis. In the MMRp/MSS population receiving subsequent PEM-LEN, HR of RPSFT-adjusted OS was also consistent at 0.77.
Conclusions: Adjusted OS using RPSFT for subsequent use of IO in the overall and MMRp/MSS populations, including PEM-LEN in the MMRp/MSS population, showed limited impact on survival benefits, supporting frontline use of dostarlimab+CP as standard of care in all patients with pA/rEC.
Previously presented at the European Society of Medical Oncology Congress 2024, poster/oral: 731P, Mirza MR, et al. – reused with permission.