Top-line results from the phase 3 KEYNOTE-C93 trial showed that pembrolizumab (Keytruda) alone significantly improved progression-free survival compared with standard carboplatin and paclitaxel chemotherapy in patients with mismatch repair-deficient (dMMR) advanced or recurrent endometrial cancer. The study enrolled 299 patients who had not received prior systemic chemotherapy. A positive trend in overall survival was also seen, although the data are not yet mature.
Pembrolizumab also demonstrated clinically meaningful objective response, complete response, and duration of response rates. No new safety concerns were reported, and the treatment’s safety profile was consistent with previous studies.
The findings make pembrolizumab the first PD-1 inhibitor to outperform standard platinum-based chemotherapy as a standalone first-line treatment for this patient group. Researchers say the results could provide a chemotherapy-free option for patients with dMMR endometrial cancer, potentially reducing treatment-related side effects while maintaining strong clinical benefits. Mature overall survival data will help determine the long-term value of this approach.