Endometrial Cancer: Elahare and Keytruda Lead the ADC and ICI Path

Elahere and Keytruda are leading the path for combination therapy of ADC and ICI for endometrial cancer.

During a recent 2024 Annual meeting of the American Association for Cancer Research (AACR), promising data from a Phase II trial were presented. The outcome of the trial proved the effectiveness of the combination treatment involving Immunogen's antibody-drug conjugate (ADC) Elahere and Merck & Co's immune checkpoint inhibitor (ICI) Keytruda in addressing folate receptor-alpha (FR-α) positive recurrent microsatellite stable / mismatch repair proficient serous endometrial cancer ().

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What is Endometrial Cancer

Endometrial cancer is also known as uterine cancer, which occurs in the lining of the uterus (endometrium). It is 4th most common cancer among women. There are various treatment options available. However, this new study will pave the way for advancement in the treatment of this cancer.

Market Potential of Endometrial Cancer

GlobalData, a leading data and analytics company, commented that with the ongoing success, Elhare will not only establish a strong presence in the endometrial cancer market but also lay the foundation for innovative treatment approaches involving ADC and immunotherapy.

GlobalData's patient-centric forecast indicated that the endometrial cancer market is estimated to achieve a value of $7.9 billion by the year 2030 in the United States.

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Future Synergy Between ADC and ICI

Based on these promising results, an investigative molecular analysis wasconducted to find the biomarkers that could potentially predict responses. Even though the response did not seem to be influenced by FR-α expression, the analysis might be constrained due to the limited number of samples.

The Oncology & Hematology Analyst at GlobalData, Jasminemay Barcelon mentions: “If synergism between these two classes is confirmed, thenovel combination could be utilized for other indications withoverexpressed FR-α. A continued expansion study is indicated to assess

whether the responses were dependent on or driven by FR-α expression. Additionally, increasing the duration of response should be a continuedfocus.”

Keytruda (Pemrolizumab), an immunotherapy drug, has already obtained approvals for two advanced endometrial cancer indications and for an additional 13 oncology indications. GlobalData's analyst consensus forecast predicts that its sales will reach $22.7 billion by 2030.

Elahere (Mirvetuximab Soravtansine-Gynx) recently got complete approval for platinum-resistant ovarian cancer, as the first and only ADC ().

There is a probability that Elahere will get label expansion for ovarian cancer, as well as other indications like non-small cell lung cancer and triple-negative breast cancer with high FR-a expression. The approval of Elahere in ovarian cancer, along with its companion diagnostic VENTANA FOLR1 assay, could be used as a prototype for patient stratification based on biomarkers.

Barcelon concluded that Keytruda continues to dominate the immune checkpoint inhibitor market in terms of commercial success, in spite of facing oversaturation. Elahere, on the other hand, has the potential to be the first to market in treating endometrial cancer. However, it will encounter competition from other prospective ADC agents that may have a higher patient population due to lower FR-α expression levels or reduced lung and ocular toxicities.

Although further encouraging clinical outcomes could result in more approvals for Elahere and cater to the urgent needs of FR-α-positive patients with a severe form of endometrial cancer, only a small proportion of patients will benefit from this.

In summary, the report highlights the significant potential of the combination of ADCs and immunotherapies as a viable strategy to address ICI resistance and improve the treatment of individuals diagnosed with solid tumors.

References:

Therapeutic strategies targeting folate receptor α for ovarian cancer - (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10499382/)
Keytruda - (https://www.ema.europa.eu/en/medicines/human/EPAR/keytruda)

Source-Medindia

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