# Chemotherapy + PD-1/PD-L1 blockade, first-line advanced endometrial cancer

Source: https://onco.cc/pairings/chemo-io-first-line-endometrial/  
OnCo record `chemo-io-first-line-endometrial` (Pairing). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Three trials with three different antibodies agree: adding immunotherapy to first chemotherapy for advanced endometrial cancer roughly triples progression-free time in dMMR tumours and helps the rest modestly.

## Summary

Adding a PD-1 or PD-L1 antibody to first-line carboplatin-based chemotherapy for advanced or recurrent endometrial cancer is a combination pairing supported by three positive phase 3 trials with three different antibodies: RUBY with dostarlimab, NRG-GY018 / KEYNOTE-868 with pembrolizumab, and DUO-E with durvalumab with or without olaparib. Tumours with mismatch repair deficiency carry thousands of neoantigens and gain the most, while chemotherapy provides antigen release and lymphodepletion that appear to extend a more modest benefit into mismatch repair-proficient disease. RUBY also demonstrated an overall survival benefit. The consistency across these trials makes it the most reliably replicated regimen in gynaecological oncology.

## Fields

- Kind: Pairing
- Last checked: 2026-09-07
- Pairs: Immune checkpoint inhibitors + Carboplatin
- Type: combination
- Rationale: dMMR tumours carry thousands of neoantigens; chemotherapy provides antigen release and lymphodepletion that appear to extend benefit into pMMR disease.
- Evidence: Three positive phase 3 trials; OS benefit shown in RUBY.

## Sources

- ClinicalTrials.gov NCT03981796: RUBY / ENGOT-EN6 / GOG-3031: https://clinicaltrials.gov/study/NCT03981796
- ClinicalTrials.gov NCT03914612: NRG-GY018 / KEYNOTE-868: https://clinicaltrials.gov/study/NCT03914612

## Connected records

- cancers: [Advanced or recurrent endometrial cancer](https://onco.cc/cancers/advanced-recurrent-endometrial-cancer/), [Endometrial cancer](https://onco.cc/cancers/endometrial/), [Mismatch-repair-deficient endometrial cancer](https://onco.cc/cancers/endometrial-mmr-deficient/)
- drugs: [Carboplatin](https://onco.cc/drugs/carboplatin/), [Dostarlimab](https://onco.cc/drugs/dostarlimab/), [Durvalumab](https://onco.cc/drugs/durvalumab/), [Pembrolizumab](https://onco.cc/drugs/pembrolizumab/)
- terms: [Microsatellite instability (MSI-H) / mismatch repair deficiency (dMMR)](https://onco.cc/terms/msi/)
- trials: [DUO-E / GOG-3041 / ENGOT-EN10](https://onco.cc/trials/duo-e/), [NRG-GY018 / KEYNOTE-868](https://onco.cc/trials/nrg-gy018-keynote-868/), [RUBY / ENGOT-EN6 / GOG-3031](https://onco.cc/trials/ruby/)
- technologies: [Immune checkpoint inhibitors](https://onco.cc/technologies/checkpoint-inhibitor/)

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JSON: https://onco.cc/api/v1/entities/chemo-io-first-line-endometrial.json