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3

Indication details

Combined Agent(s)
Carboplatin and paclitaxel
Control Arm
Carboplatin, paclitaxel, and placebo (arm A)
Therapeutic Indication
FDA: Durvalumab is indicated with carboplatin plus paclitaxel followed by single-agent durvalumab for adult patients with primary advanced or recurrent endometrial cancer that is mismatch repair deficient (dMMR). EMA: Durvalumab in combination with carboplatin and paclitaxel is indicated for the first-line treatment of adults with primary advanced or recurrent endometrial cancer who are candidates for systemic therapy followed by maintenance treatment with durvalumab as monotherapy in endometrial cancer that is mismatch repair deficient (dMMR)
Tumour Type
Gynaecological Malignancies
Tumour Sub-type
Endometrial Cancer
Tumour Stage
Primary advanced or recurrent
Trial Name
DUO-E
NCT Number
NCT04269200
Trial Phase
Phase III

Approval details

FDA Approval
FDA approval June 2024
EMA Approval
EMA (CHMP) June 2024. EC decision August 2024
Comment
Monotherapy treatment in ITT (durvalumab only, arm B). Approval based on pre-specified, exploratory subgroup analysis in dMMR: PFS HR 0.42 (0.22-0.80) and 7 months for control PFS. PFS NR for the Durvalumab arm: estimated gain 9.7 months.

Primary Outcome(s)

Primary Outcome(s)
PFS (investigator assessment)
Evaluated Outcome
PFS (ITT)
Form(s)
Form 2b

Outcome Data

PFS Control
9.6 months
PFS Gain
0.6 months, >10% gain at 24 months
PFS HR
0.71 (0.57-0.89)
OS Control
25.9 months (interim analysis)
OS Gain
NR (estimated 7.7 months)
OS HR
0.77 (0.56-1.07) NS (p=0.12)

Adjustments

QoL Comment
QoL data pending

Final Score (after adjustments)

Preliminary non-curative score

2

Long-term plateau in the PFS curve
5% available at 24m
Final non-curative score

3

Scorecard details

ESMO-MCBS version
ESMO-MCBS v1.1
Scorecard ID
452
Scorecard version
1
Issue date
24.07.2024
Durvalumab DUO-E

PRELIMINARY SCORE

PFS

ADJUSTMENTS

?
QoL data pending
Long-term plateau in the PFS curve
Durvalumab DUO-E

FINAL SCORE

Overall Survival / Disease-Free Survival / Pathological Complete Response
Overall Survival
3
Progression-Free Survival
Non-inferiority (Improved Quality of Life or Reduced Adverse Events) / Response Rate
Overall Response Rate / Duration of Response
Gynaecological Malignancies
FDA: Durvalumab is indicated with carboplatin plus paclitaxel followed by single-agent durvalumab for adult patients with primary advanced or recurrent endometrial cancer that is mismatch repair deficient (dMMR). EMA: Durvalumab in combination with carboplatin and paclitaxel is indicated for the first-line treatment of adults with primary advanced or recurrent endometrial cancer who are candidates for systemic therapy followed by maintenance treatment with durvalumab as monotherapy in endometrial cancer that is mismatch repair deficient (dMMR)
Durvalumab + Carboplatin and paclitaxel
Carboplatin, paclitaxel, and placebo (arm A)

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    Legend

    Information about symbols, abbrevations and color codes

    Red = negative
    Green = positive
    Grey = neutral
    ? Grey + ? = neutral with pending data
    DFS
    Disease-Free Survival
    DoR
    Duration of Response
    EFS
    Event-Free Survival
    HR
    Hazard Ratio
    NEB
    No evaluable benefit
    NI
    Non-inferiority Study
    ORR
    Overall Response Rate
    OS
    Overall Surival
    pCR
    Pathological Complete Response/Remission
    PFS
    Progression-Free Survival
    QoL
    Quality of Life
    RFS
    Relapse-Free Survival
    RR
    Response Rate

    QoL adjustments

    Other adjustments*

    Serious and disabling adverse effects

    Red = negative / deterioration

    Green = positive / improvement

    QoL adjustments

    Red = negative / deterioration

    Green = positive / improvement

    Other adjustments*

    Red = negative / deterioration

    Green = positive / improvement

    Serious and disabling adverse effects

    Red = negative / deterioration

    Green = positive / improvement

    * Other adjustments include:

    - Long-term plateau in the survival curve
    - Long-term plateau in the PFS curve
    - Early stopping or crossover
    - Only improved PFS mature data shows no OS advantage and no improved Qol.

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