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New treatment option for dMMR endometrial cancer

Tamlen's picture
Tamlen
Posts: 323
Joined: Jan 2018

Dostarmilab (brand name Jemperli), a monoclonal antibody, has received accelerated approval for recurrent/advanced endometrial cancer associated with deficient mismatch repair (dMMR) and previously treated with platinum-containing chemotherapy.

Here's the press release: PD-1 Inhibitor Approved for dMMR Endometrial Cancer

I believe this is for cancers with microsatellite instability (like Lynch syndrome). Maybe someone else familiar with dMMR can confirm this? I'm microsatellite stable, so I don't know about dMMR.

SF73
Posts: 316
Joined: Oct 2017

How wonderful! Thanks for sharing, Tamlen!

Dak82's picture
Dak82
Posts: 92
Joined: Dec 2020

I am dMMR based on MLH1 methylation positive. My MSI status is now considered inconcludive. Keytruda (Pembrolaziamb) became option since it also addresses dMMR.

TeddyandBears_Mom's picture
TeddyandBears_Mom
Posts: 1807
Joined: Jun 2015

Thanks for sharing Tamlen. Another tool in our toolbox.

cmb's picture
cmb
Posts: 749
Joined: Jan 2018

My understanding is that microsatellite instability (MSI-H) results from impaired DNA mismatch repair (dMMR). While some instances of MSI-H/dMMR are caused by Lynch Syndrome, others result from somatic mutations in the tumor itself.

As someone with Lynch, I'm always interested in new treatments for MSI-H/dMMR. Thanks for posting,

Dak82's picture
Dak82
Posts: 92
Joined: Dec 2020

I am MSI which led to testing of the MLH1 gene for Lynch. When it came back positive for methylation Lynch was ruled out. So I am looking at dMMR even though the methylation occurred--methylation can have the same effect--the gene doesn't work and the end result is that chemo doesn't work. So Keytruda is approved for dMMR and MSI-H tumors and Jemperli is approved for dMMR. I think they work roughly the same way. I feel like I need to take a biology class!

Deb

Dak82's picture
Dak82
Posts: 92
Joined: Dec 2020

Got my first Pembro infusion this week. So far side effect free. Interesting note relevant to this thread. My docs tried to get this new drug because my most recent tumor test showed MSI undetermined. But I do have the BRCA 2 mutation. So the decision was made to start Pembro and move to the dostarlimab when it becomes available. Fingers crossed.

 

Deb

Afoste3
Posts: 29
Joined: Jun 2020

Hi Deb,

 

I'm here to support my mom and I've been following your posts--it's good to hear you started a new treatment, I hope it goes well and you stay side effect-free.  I'll be sending you good thoughts that you see results soon!

 

Anne-Marie

Dak82's picture
Dak82
Posts: 92
Joined: Dec 2020

I had my first Keytruda infusion on 12 May. So far so good. Only some chest pain. BP is finally down so doc is letting me come off the amlodipine which was likely causing lower leg edema. Not comfortable when combined with minor neuropathy!

Will keep all posted on progress especially if I get moved to dostarlimab when it's more widely available.

Cheers,

Deb

Dak82's picture
Dak82
Posts: 92
Joined: Dec 2020

Had my second Keytruda infusion last Tuesday then hightailed it to Florida for a family get together. It has been great! I chose to get a port which I didn't do for chemo; the thinking was I would only have 6 sessions and press on. Of course it didn't work that way. I've had almost no side effects so far another than chest/rib cage discomfort. I keep feeling like I have a bad stitch when I breathe but the feels g varies a lot through the day. I found Alleve helps. I will say that I'm almost hoping for a sign this stuff is doing something after the chemo failure. Ah well. I have an X-ray scheduled for 12 July to check progress after #3 and the day before #4.

Here's the interesting part. The onc nurse called me and said we'll be switching to dostarlimab for #4. I will keep everyone posted and on the journey through immunotherapy. I feel very good but have noticed some coughing generated by heavy breathing. The ureteral stent is keeping me from running but I'm still walking miles and cycling as much as I can.

I hope everyone is in good health as we break out of our national nightmare!

Hugs to all,

Deb

TeddyandBears_Mom's picture
TeddyandBears_Mom
Posts: 1807
Joined: Jun 2015

Thanks for the great update Deb. I hope you have an amazing trip while in Florida. 

Here's to looking forward to positive progress before your #4!

Love and Hugs,

Cindi

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