Gynecologic

Question 1

2nd Line treatment of recurrent or metastatic endometrial cancer

Answer 1

Pembrolizumab + lenvatinib

Question 2

First line treatment of recurrent, persistent or metastatic cervical cancer:
A. PDL1 negative
B. PDL1 CPS > 1
C. NEC/Small Cell Cervical Cancer

Answer 2

A. PD-L1 negative: Paclitaxel, cisplatin/carboplatin, + bevacizumab
B. PD-L1 CPS ≥1: Pembrolizumab + cisplatin/paclitaxel ± bevacizumab
C. NEC/Small Cell Cervical Cancer
- Cisplatin and etoposide
- Topotecan, paclitaxel, and bevacizumab
- Cisplatin/etoposide + atezolizumab
(or durvalumab)

Question 3

Second line/Subsequent treatment of metastatic cervical cancer (3)

Answer 3

• TMB-H tumors or PD-L1–positive or MSI-H/dMMR
  tumors: Pembrolizumab
• Tisotumab vedotin-tftv
• Cemiplimab

Question 4

Indication for use of nivolumab in cervical cancer

Answer 4

Useful in certain circumstances for patients with recurrent/metastatic cervical cancer who received at least one prior chemotherapy regimen and PDL1 positive (Checkmate-358)

Question 5

Preferred adjuvant + systemic treatment regimen for endometriod carcinoma

Answer 5

Adjuvant:
Cisplatin plus RT followed by carboplatin/paclitaxel

Systemic:
Carboplatin/paclitaxel/pembrolizumab or dosarlimab

Question 6

Treatment of surgically staged III to IV endometrioid cancer and preferred systemic therapy regimens (4)

Answer 6

Systemic therapy [chemotherapy] +/- immunotherapy +/- vaginal brachytherapy +/- EBRT

Systemic therapy [Preferred regimens]: irrespective of PDL1
*Carboplatin + Taxol [normally 6 cycles if Radiation is not given]
*Carboplatin + Taxol + Pembrolizumab [For Stage III-IV tumors, except for Carcinosarcoma]
*Carboplatin + Taxol + Dostarlimab-gxly [For Stage III-IV tumors]
*Carboplatin + Taxol + Herceptin [For Stage III or IV Her2+ uterine serous cancer or carcinosarcoma]