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Impact of Molecular Classification on Treatment Paradigms in Uterine Cancers

Authors
  • Cosgrove, Casey M1
  • Barrington, David1
  • Backes, Floor J.1
  • 1 The Ohio State University College of Medicine, The James Cancer Hospital and Solove Research Institute, M-210 Starling-Loving, 320 West 10th Avenue, Columbus, OH, 43210-3078, USA , Columbus (United States)
Type
Published Article
Journal
Current Oncology Reports
Publisher
Springer-Verlag
Publication Date
May 03, 2021
Volume
23
Issue
7
Identifiers
DOI: 10.1007/s11912-021-01073-3
Source
Springer Nature
Keywords
License
Yellow

Abstract

Purpose of ReviewThis article will discuss the recent data on the prognostic significance of molecular classification of endometrial carcinoma, as well as its impact on directing treatment decisions.Recent FindingsMolecular classification has emerged as a complement to the current paradigm of endometrial cancer (EC) risk stratification. POLE mutations appear to portend favorable prognoses, but data are insufficient to indicate withholding treatment based on this signature. Copy number high (CNH) EC carries a worse prognosis and may benefit from more aggressive therapy. MMRd tumors are likely to have other prognostic features that indicate adjuvant treatment and many recurrences respond favorably to pembrolizumab. Progression of molecular profiling may allow further discrimination of the no specific molecular profile (NSMP) group. Treatment for this group remains largely based on conventional risk factors. For both the NSMP and the CNH groups, treatment with lenvatinib and pembrolizumab is an attractive contemporary option for recurrence management.SummaryMolecular classification is a useful adjunct to conventional risk stratification paradigms for both prognostic counseling and treatment selection. Clinical trials incorporating molecular signatures in assigning treatment strategies may further elucidate the value of this classification system.

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