Advanced endometrial cancer, a targeted drug linked to longer survival
· BehindLines newsroom · Updated
An international phase 3 trial called TroFuse-005 reports that sacituzumab tirumotecan ("sac-TMT") gave better results than chemotherapy in women with previously treated advanced or recurrent endometrial cancer. The results were presented at the congress of the European Society for Medical Oncology (ESMO) and published in The Lancet: NYU Langone places the presentation on 26 October 2026. The most recent mainstream coverage, from Medical News Today, is dated 2 November; the scientific announcement itself is therefore a week old.
The drug and the disease
Sac-TMT is an antibody-drug conjugate: an antibody that recognises the protein Trop-2, found in large amounts on the surface of many cells of this cancer, is linked to a cytotoxic molecule of the topoisomerase I inhibitor type. According to Medical News Today, the linker is designed to stay stable in the blood and to release its payload inside the tumour cell, with a possible effect on neighbouring cells. Endometrial cancer affects the lining of the uterus. According to a physician quoted by NYU Langone, an estimated 68,000 new uterine cancer cases are expected in the United States in 2026, with more than 14,000 deaths a year.
What the trial shows
According to the ASCO Post and Medical News Today, 776 patients were randomly assigned to sac-TMT (386) or to physician's-choice chemotherapy, for example doxorubicin or paclitaxel (390). According to sponsor Merck, participants had received platinum-based chemotherapy and anti-PD-1 or anti-PD-L1 immunotherapy, together or separately. The trial ran in more than 200 centres in 29 countries. NYU Langone describes the lack of an established standard of care in this situation.
Sac-TMT improved both primary endpoints, progression-free and overall survival, and objective response rate, a key secondary endpoint. Figures reported by the ASCO Post:
- progression-free survival: median of 7.2 months versus 3.9 months, a 41% lower risk of progression or death (hazard ratio 0.59; 95% confidence interval 0.50 to 0.70);
- overall survival: median of 19.0 months versus 12.1 months (hazard ratio 0.68; interval 0.55 to 0.84), about seven months longer;
- objective response rate: 35.1% versus 17.3%, with a median duration of response of 11.1 months versus 6.9 months.
Quality of life reported by the patients remained stable over time, the sources specify.
Side effects and limits
Adverse events of grade 3 or higher related to treatment were more frequent with sac-TMT: 54.4% versus 41.4%, according to the ASCO Post, with anaemia among the reported effects. Other effects cited are a drop in white blood cells, inflammation of the mouth, and dry or itchy eyes. Medical News Today reports that treatment was stopped because of treatment-related adverse events in 3.1% of cases on sac-TMT versus 4.9% on chemotherapy. Treatment-related deaths were 0.8% in each group.
Several caveats apply. Median follow-up is only 14 months, so the survival analysis is still early. The study is funded by Merck & Co., which makes both sac-TMT and pembrolizumab, and the lead investigator, Bhavana Pothuri, discloses financial ties to industry, which NYU Langone says it manages under its policies. Longer-term safety remains to be assessed, and the drug's value in other cancers that express Trop-2 is only a hypothesis.
Reactions and next steps
According to NYU Langone, Bhavana Pothuri considers that these data establish sac-TMT as a new standard treatment for recurrence and that clinical guidelines will need to be reassessed. Domenica Lorusso, of Humanitas University in Milan, quoted by Medical News Today, calls the results "highly significant" and says the US FDA has accepted the marketing application for priority review. The FDA’s acceptance of an application for priority review does not constitute marketing approval. This article reports on a single clinical trial and is general information.