{"entity":{"id":"chemo-io-first-line-endometrial","kind":"pairing","name":"Chemotherapy + PD-1/PD-L1 blockade, first-line advanced endometrial cancer","aka":[],"tldr":"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.","asOf":"2026-09-07","links":[{"label":"ClinicalTrials.gov NCT03981796: RUBY / ENGOT-EN6 / GOG-3031","url":"https://clinicaltrials.gov/study/NCT03981796"},{"label":"ClinicalTrials.gov NCT03914612: NRG-GY018 / KEYNOTE-868","url":"https://clinicaltrials.gov/study/NCT03914612"}],"tags":[],"related":[],"cancers":["endometrial"],"sections":[],"technologies":[],"targets":[],"drugs":["dostarlimab","pembrolizumab","durvalumab"],"companies":[],"institutions":[],"pathways":[],"terms":["msi"],"trials":["ruby","nrg-gy018-keynote-868","duo-e"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"a":"checkpoint-inhibitor","b":"carboplatin","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.","pairingType":"combination"},"route":"/pairings/chemo-io-first-line-endometrial/","neighbours":{"cancer":[{"id":"advanced-recurrent-endometrial-cancer","kind":"cancer","name":"Advanced or recurrent endometrial cancer","route":"/cancers/advanced-recurrent-endometrial-cancer/"},{"id":"endometrial","kind":"cancer","name":"Endometrial cancer","route":"/cancers/endometrial/"},{"id":"endometrial-mmr-deficient","kind":"cancer","name":"Mismatch-repair-deficient endometrial cancer","route":"/cancers/endometrial-mmr-deficient/"}],"drug":[{"id":"carboplatin","kind":"drug","name":"Carboplatin","route":"/drugs/carboplatin/"},{"id":"dostarlimab","kind":"drug","name":"Dostarlimab","route":"/drugs/dostarlimab/"},{"id":"durvalumab","kind":"drug","name":"Durvalumab","route":"/drugs/durvalumab/"},{"id":"pembrolizumab","kind":"drug","name":"Pembrolizumab","route":"/drugs/pembrolizumab/"}],"term":[{"id":"msi","kind":"term","name":"Microsatellite instability (MSI-H) / mismatch repair deficiency (dMMR)","route":"/terms/msi/"}],"trial":[{"id":"duo-e","kind":"trial","name":"DUO-E / GOG-3041 / ENGOT-EN10","route":"/trials/duo-e/"},{"id":"nrg-gy018-keynote-868","kind":"trial","name":"NRG-GY018 / KEYNOTE-868","route":"/trials/nrg-gy018-keynote-868/"},{"id":"ruby","kind":"trial","name":"RUBY / ENGOT-EN6 / GOG-3031","route":"/trials/ruby/"}],"technology":[{"id":"checkpoint-inhibitor","kind":"technology","name":"Immune checkpoint inhibitors","route":"/technologies/checkpoint-inhibitor/"}]}}