Metastatic endometrial carcinoma responsive to pembrolizumab

Carcinoma of the endometrium is the second most common and the fourth leading cause of mortality due to gynecological cancer among women worldwide. About 80% of endometrial carcinomas present as localized disease and have a 5-year survival rate of more than 95%. Most of the recurrent and metastatic endometrial cancers have a poor prognosis, and the response to chemotherapy is poor. The treatment options for advanced and recurrent endometrial carcinoma are limited. Several trials investigated the role of immune checkpoint inhibitors in endometrial cancer. Based on these trials, pembrolizumab was approved for individuals with unresectable recurrent or metastatic disease. In the current era of advancing immunotherapy, identification of mismatch repair deficiency or microsatellite instability status can predict response to drugs like pembrolizumab. Here, we report a 62-year-old lady with metastatic endometrial cancer who progressed on first-line therapy with lung and lymph nodal metastases. She was oxygen dependent and was bedridden. As she was not fit for chemotherapy, and her MSI status was found to be unstable, she was treated with pembrolizumab and had a remarkable recovery.