The SIENDO study

The ENGOT EN5 SIENDO study focuses on advanced or recurrent endometrial cancer. Initially, patients received a minimum of 12 weeks of TC (Taxol-Carbo) chemotherapy, followed by treatment with selinexor, an export protein inhibitor. While the primary outcome, progression-free survival, was not met in the overall population, a post hoc analysis revealed significant benefits for patients with TP53 wild-type tumours.

Updated results show that among the 77 TP53 wild-type patients, those treated with selinexor had a median PFS of 28.4 months compared to just 5 months in the placebo group. The benefit was even more pronounced in the pMMR TP53 wild-type population, with a PFS of 39.5 months versus 5 months for the placebo arm. Similarly, TP53 wild-type patients with MMRd tumours also benefited, showing a median PFS of 30 months compared to 3.7 months for the placebo group.

These encouraging results underscore the potential of selinexor for patients with advanced or recurrent TP53 wild-type endometrial cancer. They form the basis for the ongoing ENGOT-EN20 trial, which is enrolling patients with locally advanced or first recurrent TP53 wild-type endometrial cancer. Participation in this trial is strongly encouraged to validate these findings further.