Endometrial cancer: the individual approach

Endometrial cancer is the most common gynaecological cancer and often has good outcomes. Unfortunately, for a substantial number of women who present with advanced disease or recurrence the prognosis is poor. Treatment options for metastatic and advanced cancer have been limited to chemotherapy or hormone therapy and even with carboplatin and paclitaxel the median progression-free survival is just slightly more than 1 year. 1 Miller DS Filiaci VL Mannel RS et al. Carboplatin and paclitaxel for advanced endometrial cancer: final overall survival and adverse event analysis of a phase III trial (NRG Oncology/GOG0209). J Clin Oncol. 2020; 38: 3841-3850 Crossref PubMed Scopus (110) Google Scholar However, there is hope for survival to improve. The molecular classification of endometrial cancer into four subgroups (ultramutated DNA polymerase epsilon [POLE], microsatellite instability hypermutated, low copy number, and high copy number), and integration into the 2022 European Society for Medical Oncology clinical guidelines, 2 Oaknin A Bosse TJ Creutzberg CL et al. Endometrial cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up. Ann Oncol. 2022; 33: 860-877 Summary Full Text Full Text PDF PubMed Scopus (59) Google Scholar provides improved prognostic information and an opportunity for a personalised biomarker-driven approach to treatment using targeted therapy. Carboplatin and paclitaxel plus avelumab compared with carboplatin and paclitaxel in advanced or recurrent endometrial cancer (MITO END-3): a multicentre, open-label, randomised, controlled, phase 2 trialAdding avelumab to first-line chemotherapy deserves further testing in patients with advanced or recurrent endometrial cancer, although consideration of mismatch repair status is warranted. Full-Text PDF