An Exceptional Response to Dostarlimab in Mismatch Repair Deficient, Microsatellite Instability-High and Platinum Refractory Endometrial Cancer
, Giorgio Giorda 2, Alessandra Viel 3, Mara Fornasarig 4, Adrian Zdjelar 5, Enrica Segatto 5, Roberto Sorio 1, Serena Corsetti 1, Simona Scalone 1, Milena Sabrina Nicoloso 1, Tania Pivetta 1,6, Emilio Lucia 2, Nicolò Clemente 2, Elisa Palazzari 7, Vincenzo Canzonieri 8,9 and Fabio Puglisi 1,6Round 1
Reviewer 1 Report
In the present work, Bartoletti and colleagues present a case study of a 78-years-old woman that, after undergoing radical hysterectomy with pelvic lymphadenectomy for FIGO stage I, high grade endometrioid adenocarcinoma with substantial lymphovascular space invasion, underwent metastatization (lungs and liver) despite receiving first-line chemotherapy with 6 cycles of carboplatin AUC 5 and paclitaxel. Having been found mismatch repair deficient and with high microsatellite instability, the patient received cycles of increasing doses of dostarlimab, a humanized anti-PD-1 monoclonal antibody, that was well tolerated and lead to an almost complete disappearance of lung lesions and to a very noticeable reduction of liver metastases.
This case study is convincing, well-written and effective in demonstrating the benefits that dMMR/MSI patients could have receiving single agent anti-PD1, sparing the well-known toxicity of combined therapies. In its current form, it is already suitable for publication.
It would be interesting, though, if the Authors could add some information in the last paragraph of the Discussion, briefly describing which could be some of the genetic alterations that could encourage single- over combined-agents therapies.
MINOR: there are also a few typos that the Authors might want to fix: line 105 (replace "more others" with "several others"); line 107 (replace "in facts" with "in fact"); line 108 ("overexpress" and "seems" should be conjugated in the same way: I suggest using "overexpresses"/"seems"); line 131 (replace "treat" with "treated"). Also check the URLs of citations 2, 8 and 10 because they seem broken.
Author Response
Please see the attachment
Author Response File: 
Author Response.docx
Reviewer 2 Report
I don't have any bigger concerns. The paper properly presents clinical issue, which is deeply problematic and challenging. The presentation is fairly clear and easy for the reader. The references are rather short, however like for case study it seems enough.
Author Response
Please see the attachment
Author Response File: Author Response.docx
