FIRST-LINE TREATMENT FOR ADVANCED OR METASTATIC ENDOMETRIAL CANCER IN 2025
DOI:
https://doi.org/10.54695/cf.004.1.0035Keywords:
endometrial cancer, advanced, relapse, chemotherapy, immune checkpoint inhibitor, molecular biology.Abstract
Endometrial cancer is the second most common gynecological cancer after breast cancer. TCGA analysis has classified these tumors into four subtypes with distinct molecular profiles: POLEmutated, MMRd, TP53m, and NSMP. These tumor subtypes have different prognoses that are currently not considered in first-line metastatic treatment. Treatment of locally advanced or metastatic disease is based on a chemotherapy/anti-PD1 combination: Carboplatin, Paclitaxel and Dostarlimab. This combination demonstrated a 6-month increase in progression-free survival (PFS) in the RUBY trial. Hormone therapy remains a first-line option for a very limited population (slowly progressive tumors with high hormone receptor expression). The question of a therapeutic de-escalation in the MMRd population is raised by the DOMENICA trial currently recruiting where Dostarlimab is compared to Carboplatin Taxol.
