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Molecular Classification to Predict Prognosis and Relapse Patterns Among Patients With Low/Intermediate-Risk Endometrial Cancer
According to results from a retrospective cohort study, molecular classification can predict prognosis and relapse patterns among patients with low or intermediate-risk endometrial cancer.
“The role of molecular classification in patients with low/intermediate risk endometrial cancer is uncertain,” stated Kristina Lindemann, MD, PhD, Oslo University Hospital, Norway, and coauthors. This study “aimed to determine the association of molecular profiling with patterns of relapse and survival.”
In this study, researchers classified 610 patients with low or intermediate-risk endometrial cancer as pathogenic polymerase epsilon (POLE)-mutated (n = 57), mismatch repair deficient (n = 202), p53 abnormal (n = 34), or no specific molecular profile (n = 317). The primary end points included time to recurrence (TTR) and cancer-specific survival (CSS).
After a median follow-up of 8.9 years, there was a statistically significant difference in TTR and CSS by molecular group. Patients with p53 abnormal tumors had poorer prognosis, with 10 of the 12 relapsed patients presenting with para-aortic/distant metastases. POLE-mutated patients had excellent prognosis. Among patients with no specific molecular profile, L1CAM expression was associated with shorter CSS but not TTR.
“The differences in outcome by molecular groups are driven by differences in relapse frequency and patterns and demand a higher precision in diagnostics, also in patients with low/intermediate risk [endometrial cancer],” concluded Dr Lindemann and coauthors. “Tailored adjuvant treatment strategies need to consider systemic treatment for patients with p53 abnormal tumors and de-escalated treatment for patients with POLE mutated tumors.”
Source:
Lindemann K, Klidal W, Kleppe A, et al. Impact of molecular profile on prognosis and relapse pattern in low and intermediate risk endometrial cancer. Eur J Cancer. Published online: January 31, 2024. doi: 10.1016/j.ejca.2024.113584
