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.
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)
You might have a targeted drug with immunotherapy for:
previously treated advanced womb cancer
womb cancer that has come back (recurrent womb cancer)
You might have immunotherapy:
on its own for 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
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.
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 . Cisplatin and carboplatin are types of platinum chemotherapy drugs
you can't have surgery or radiotherapy
Some people may have pembrolizumab on its own.
You may have pembrolizumab with the chemotherapy drugs carboplatin and paclitaxel. You may have this combination as a first treatment for advanced womb cancer or cancer that has come back after treatment (recurrent womb cancer). You have this treatment for up to 2 years.
Find out about chemotherapy for womb cancer
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 (MMRd) or (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)
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.
Read about access to treatment
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.
Find out how you have cancer drugs
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.
Last reviewed: 23 Apr 2024
Next review due: 23 Apr 2027
Your treatment depends on several factors. These include what type of womb cancer you have, how big it is, whether it has spread (the stage) and the grade. It also depends on your general health.
Current research is looking at diagnosing and treating womb cancer.
There is support available during and after treatment to help you cope. This includes support from your clinical nurse specialist, cancer charities, community services, and family and friends.
Sometimes womb cancer is advanced when it is first diagnosed. Or the cancer has come back and spread after treatment for the original cancer.
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