Pioneering preoperative anti-PD-1 immunotherapy enables curative resection in dMMR advanced/recurrent endometrial carcinoma: a case series (2020-2022).

Huijiao Fu, Bo Yang, Jing Li, Xingxin Zhu, Yunjun Yang, Songhua Yuan

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Article in Discover oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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6 authors.

Huijiao FuDepartment of Obstetrics and Gynecology, The First People's Hospital of Foshan (Foshan Hospital Affiliated to Southern University of Science and Technology), School of Medicine, Southern University of Science and Technology, Foshan, 528000, China.

Bo YangDepartment of Obstetrics and Gynecology, The First People's Hospital of Foshan (Foshan Hospital Affiliated to Southern University of Science and Technology), School of Medicine, Southern University of Science and Technology, Foshan, 528000, China.

Jing LiDepartment of Pathology, The First People's Hospital of Foshan (Foshan Hospital Affiliated to Southern University of Science and Technology), School of Medicine, Southern University of Science and Technology, Foshan, 528000, China.

Xingxin ZhuDepartment of Pathology, The First People's Hospital of Foshan (Foshan Hospital Affiliated to Southern University of Science and Technology), School of Medicine, Southern University of Science and Technology, Foshan, 528000, China.

Yunjun YangDepartment of Radiology, The First People's Hospital of Foshan (Foshan Hospital Affiliated to Southern University of Science and Technology), School of Medicine, Southern University of Science and Technology, Foshan, 528000, China.

Songhua YuanDepartment of Obstetrics and Gynecology, The First People's Hospital of Foshan (Foshan Hospital Affiliated to Southern University of Science and Technology), School of Medicine, Southern University of Science and Technology, Foshan, 528000, China. yuan-sh09@163.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Mismatch repair-deficient (dMMR) advanced or recurrent endometrial carcinoma presents a therapeutic challenge, and the role of preoperative immunotherapy prior to its guideline incorporation (2020–2022) remained unexplored. We report three patients with dMMR endometrial carcinoma who received preoperative anti‑PD‑1 therapy (sintilimab). Case 1 (locally recurrent vaginal mass) was treated with sintilimab monotherapy, achieving a pathological complete response. Case 2 (stage IVB with bulky uterine and osseous metastases) received sintilimab combined with carboplatin/docetaxel, attaining partial response. Case 3 (recurrent disease with renal impairment) received sintilimab plus megestrol acetate, which yielded a marked biochemical response (98.6% CA125 reduction) enabling resection despite radiographic stable disease. All patients underwent R0 resection and remained recurrence‑free after a median follow‑up of 36 months, with no grade ≥ 3 adverse events. Exploratory biomarker analysis revealed cGAS‑STING pathway activation in all tumors. These findings provide early real‑world evidence that preoperative anti‑PD‑1 therapy is a feasible and effective strategy for converting unresectable dMMR endometrial carcinoma to resectable disease, supporting further investigation in larger studies.

Indexed as

Case seriesEndometrial carcinomaMismatch repair deficiencyPD-1 inhibitorPreoperative immunotherapy

Identifiers

PMID41885998

DOI10.1007/s12672-026-04917-1

PMCPMC13139558

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