Targeted and immunotherapy drugs for womb cancer
You might have 
and drugs as part of your treatment for womb cancer.
Targeted cancer drugs work by targeting the differences in cancer cells that help them to grow and survive.
Immunotherapy uses our to fight cancer. It works by helping the immune system recognise and attack cancer cells.
Some drugs work in more than one way. So, they are targeted as well as working with the immune system.
When you might have targeted and immunotherapy drugs for womb cancer
Whether you have targeted therapy and immunotherapy will depend on:
- the type of womb cancer you have
- how far the cancer has grown (the stage)
- treatment you may have already had
- whether your cancer has certain gene changes (mutations)
Targeted cancer drug
You might have a targeted drug with immunotherapy for:
- previously treated advanced womb cancer
- womb cancer that has come back (recurrent womb cancer)
Immunotherapy
You might have immunotherapy:
- on its own for previously treated advanced womb cancer or womb cancer that has come back
- with a targeted cancer drug for previously treated advanced womb cancer or womb cancer that has come back
- with platinum chemotherapy for primary advanced womb cancer or womb cancer that has come back
Tests on your womb cancer cells
Doctors look for certain changes in genes (mutations) in your womb cancer cells. They help the cells to grow and divide. They look for the following gene changes:
- mismatch repair gene (MMRd)
- p53abn
- POLE mutations
- NSMP
They usually test a sample of your womb cancer tissue from when you were first diagnosed. Or from your operation if you had one.
The results of the tests show whether a targeted cancer drug or immunotherapy is suitable for you.
Types of targeted and immunotherapy drugs for womb cancer
Pembrolizumab and lenvatinib
Pembrolizumab is a type of immunotherapy that works by helping your immune system to kill cancer cells.
Lenvatinib is a type of targeted drug called a cancer . It works in 2 ways. It stops:
- signals that tell cancer cells to grow
- cancer cells from forming new blood vessels, which they need to keep growing
Your doctor might recommend you have these drugs together if you have advanced womb cancer or cancer that has come back (recurrent womb cancer) and:
- you are on or have had
platinum chemotherapy . Cisplatin and carboplatin are types of platinum chemotherapy drugs - you can't have surgery or radiotherapy
Some people may have pembrolizumab on its own.
Dostarlimab (Jemperi)
Dostarlimab is a type of immunotherapy called a . It works by attaching to a protein called PD-1 on the surface of cancer cells. This helps the immune system to recognise and attack the cancer.
You have dostarlimab on its own or with platinum chemotherapy for womb cancer.
To have dostarlimab on its own, you need to have:
- gene changes called
mismatch repair deficient (MMRd) or microsatellite instability-high (MSI-H) - already had platinum chemotherapy
To have dostarlimab with platinum chemotherapy, you need to have:
- primary advanced womb cancer or womb cancer that has come back
- gene changes called mismatch repair deficient (MMRd) or microsatellite instability-high (MSI-H)
Are these drugs available in the UK?
New cancer drugs are licensed for use in a particular way. For example, a drug might have a license to treat a particular stage of womb cancer.
Once a drug has a license, several independent organisations approve the new cancer drugs before doctors can prescribe them on the NHS.
In England, the National Institute for Health and Care Excellence (NICE) decides which drugs and treatments are available on the NHS.
In Wales, the All Wales Medicines Strategy Group (AWMSG) advises NHS Wales. They generally follow NICE decisions but can also issue their own guidance.
The Scottish Medicines Consortium (SMC) advises NHS Scotland. Its decisions are separate from decisions made by NICE.
Not all targeted and immunotherapy drugs are available throughout the UK. It might depend on where you live whether you can have a certain drug. Your doctor can tell you what drug is available for you.
How you have targeted and immunotherapy drugs
Lenvatinib comes as capsules that you swallow whole, once a day.
You have pembrolizumab and dostarlimab treatment through a tube into your bloodstream.
You have the treatment through a drip into your arm. A nurse puts a small tube (a cannula) into one of your veins and connects the drip to it.
You may need a central line. This is a long plastic tube that gives the drugs into a large vein, either in your chest or through a vein in your arm. It stays in while you’re having treatment, which may be for a few months.
Side effects
Everyone is different and the side effects vary from person to person. The side effects you have depend on:
- which drug you have
- whether you have it alone or with other drugs
- the amount of drug you have (the dose)
- your general health
A side effect may get better or worse during your course of treatment. Or more side effects may develop as the treatment goes on.
For more information about the side effects of your treatment, go to the individual drug pages.
