Dr. Oaknin on the Rationale for the GARNET Trial in Endometrial Cancer

Ana Oaknin, MD, principal investigator, Gynecological Malignancies Group, Vall d’Hebron Institute of Oncology, head of Gynecologic Tumors Unit, senior medical oncologist and attending physician, Medical Oncology Department, Vall d’Hebron University Hospital, discusses the rationale for the phase I/II GARNET trial in endometrial cancer.

Patients with endometrial cancer can have tumors that are microsatellite stable (MSS) or microsatellite instability—high (MSI-H). However, the anti–PD-1 therapy pembrolizumab (Keytruda) is FDA approved for patients with MSI-H solid tumors, not MSS solid tumors. As such, the GARNET trial was designed to evaluate the efficacy of anti–PD-1 agents specifically in all-comers with endometrial cancer, says Oaknin.

Although MSI-H tumors have shown a particular amenability to immunotherapy, data suggest that both MSS and MSI-H respond to anti—PD-1 therapy. For example, in a phase II trial (NCT02501096) that evaluated the combination of pembrolizumab and lenvatinib (Lenvima), investigators reported responses in both patient populations, irrespective of MSI status.