ArticleGynecologic oncology reports2026
Pathological complete response following systemic therapy with carboplatin-paclitaxel plus pembrolizumab for initially unresectable mismatch repair-deficient advanced endometrial cancer: two case reports.
Article in Gynecologic oncology reports, 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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Abstract
Background: Mismatch repair-deficient (dMMR) endometrial cancer is highly sensitive to immune checkpoint inhibition. Although pembrolizumab combined with carboplatin and paclitaxel is now a first-line standard treatment for advanced or recurrent dMMR endometrial cancer, there is limited evidence regarding the effectiveness of this treatment for initially unresectable cancer. Case presentation: We report two patients with advanced dMMR endometrial cancer who achieved a pathological complete response (pCR) after initial systemic carboplatin-paclitaxel plus pembrolizumab therapy.Case 1 was a 77-year-old woman diagnosed with FIGO 2008 stage IIIB (cT3bN0M0) grade 3 endometrioid carcinoma who had suspected sigmoid colon and ureter involvement and poorly controlled diabetes mellitus. Primary surgery with complete resection was considered unfeasible because of the anticipated surgical invasiveness and high risk of postoperative complications; therefore, the initial treatment was systemic therapy with carboplatin-paclitaxel plus pembrolizumab. Marked radiologic regression was achieved, bowel resection was avoided at surgery, and a pCR was confirmed.Case 2 was a 60-year-old woman with FIGO 2008 stage IVB (cT1bN2M1) grade 1 endometrioid carcinoma with suspected metastases in the pelvic, Discussion: These cases demonstrate that chemo-immunotherapy can induce a pCR in advanced dMMR endometrial cancer and may deepen the treatment response. Conclusion: Initial carboplatin-paclitaxel plus pembrolizumab therapy may enable less invasive surgery. These findings support the investigation of less invasive approaches for dMMR endometrial cancer.
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