Complete remission of endometrial cancer stage IVC treated with multimodality treatment including immunotherapy and maintenance PARP inhibitor - A case report.

OBJECTIVE

Mismatched repair (MMR) deficient, stage IVC endometrial carcinoma (EC) are occasionally reported as cured by immune-checkpoint inhibitors (ICIs). We present an MMR proficient (MMRp) case with long-term survival.

CASE REPORT: The patient was diagnosed with EC (endometrioid, grade 3, MMRp, programmed death-ligand 1 positive) stage IVC (lung, spine/pelvic bone, paraaortic, pelvic, inguinal and presacral node metastases) with tumor extended from endometrium to cervix, vagina to vulva. After responded to chemoimmunotherapy with paclitaxel/carboplatin then liposomal doxorubicin/carboplatin, pembrolizumab and radiotherapy to pelvis/pelvic bone metastasis, the patient received definitive surgery which showed only residual EC. Olaparib was used as maintenance therapy. The patient developed isolated recurrence in presacral lymph node 2.5 years later, she underwent proton therapy and got complete remission again and maintained with olaparib. She is currently without disease 31 months since recurrence.

CONCLUSION

Initial stage IVC MMRp EC with recurrence is still potentially curable with multimodality treatment including ICI.