Dostarlimab, sold under the brand name Jemperli, is a monoclonal antibody used as a medication for the treatment of endometrial cancer. Dostarlimab is a programmed death receptor-1 (PD-1)–blocking monoclonal antibody.The most common side effects reported in the US include fatigue/asthenia, nausea, diarrhea, anemia, and constipation. Additional side effects reported in the European Union include vomiting, joint pain, itching, rash, fever, and hypothyroidism (low levels of thyroid hormones).Dostarlimab was approved for the treatment of endometrial cancer in both the United States and the European Union in April 2021.Based on the GARNET trial, Dostarlimab (Jemperli) gained accelerated approval from the Food and Drug Administration (FDA) in April 2022. Jemperlis mechanism of action allows it to act directly on cancerous cells. Follow-up appointments accompanying long-term treatments or long-term post-operative therapies are not necessary with dostarlimab. Medical uses
In the United States, dostarlimab is indicated for the treatment of adults with mismatch repair deficient (dMMR) recurrent or advanced endometrial cancer, as determined by an FDA-approved test, that has progressed on or following prior treatment with a platinum-containing regimen. Platinum-based agents such as cisplatin, carboplatin and oxaliplatin are mainstays of treatment when it comes to cancer chemotherapy treatment.
Side effects
Serious adverse reactions in >2% of patients included sepsis, acute kidney injury, urinary tract infection, abdominal pain, and fever (pyrexia).Immune-mediated adverse reactions can occur including pneumonitis, colitis, hepatitis, endocrine disease (endocrinopathies), and nephritis.The most common side effects reported while taking this medication during a trial were dyspnea, asthenia, fatigue, and nausea.Symptoms of overdose are similar to the side effect profile of the medication, so it could involve significant immune-mediated reactions. Immune-mediated adverse reactions
Dostarlimab is a monoclonal antibody that binds to PD-1 to block it from binding PD-1 ligands to remove inhibition of immune response. With this, it causes risk for immune-mediated adverse reactions. These reactions can be severe or fatal and occur in any part of the body: organs or tissues.Examples of immune-mediated adverse reactions include immune-mediated pneumonitis, colitis, hepatitis, adrenal insufficiency, hypophysitis, thyroid disorders, nephritis with renal dysfunction, and dermatologic reactions. Pregnancy and lactation
Dostarlimab can cause harm to a fetus. The death of the fetus can occur from the immune systems reaction to the fetus through the examination of its mechanism in animal studies. Dostarlimab is a human immunoglobulin G (IgG4), which could permeate through the placental barrier. This may risk harm to the developing fetus as the drug may be passed on from the mother.Data is not available regarding the presence of dostarlimab in breastmilk. Hepatotoxicity
Dostarlimab causes mild to moderate elevations to serum aminotransferase and alkaline phosphatase in 15-25% of recipients. Serum ALT elevation above five times the normal range occurs in 2-3% of recipients.