2022-RA-922-ESGO Histo-molecular characteristics of platinum-sensitive advanced endometrial cancer: data issued from the population included in the GINECO UTOLA study

Abstract

recurrence. We evaluated the results of high-dose-rate brachytherapy after radical surgery. Methodology This was a retrospective study of all patients treated consecutively at Oscar Lambret center between 2012 and 2015 by hysterectomy and adjuvant cuff vaginal brachytherapy. Four fractions of 6.2Gy each to superior third of vaginal and 5 millimetres deep were prescribed. We analysed local (vaginal) control, overall survival, recurrence-free survival, and acute and late toxicities. Local control was assessed by taking into account the cumulative incidence of local recurrence estimated by the competitive risk method. Survival analyses were performed using the Kaplan-Meier method. Results We included 250 patients; 208 were considered to be at high intermediate risk of recurrence postoperatively. After a median follow-up of 56 months, the cumulative incidence of local recurrence was 4.8% at 3 years (95% CI: 2.8-8.3) and 6.8% at 5 years (95% CI; 4.8-12.6). The 5-year overall survival was 86.2% (95% CI: 80.6-90.3) and the 5-year recurrence-free survival was 77.5% (95% CI: 71.1-82.7). Acute toxicities are occurred in 20 patients (8%), of whom 2 patients had grade !3 toxicities. One patient (0.4%) had late toxicity of grade !3. Conclusion Our results show a local recurrence rate that is 3% to 4% higher than that found in the literature, largely explained by the different selection of our patients. The overall survival remains similar to published data, suggesting the effectiveness of salvage treatments and the low impact of local recurrence on survival. The integration of molecular data with current clinical and pathological risk factors should allow a more accurate selection of patients who will benefit from adjuvant therapy.

The Shifting Landscape of p53abn Endometrial Cancers: A Review of the Prognostic and Predictive Impact and Current Therapeutic Directions

“…Results have shown a mPFS of 5.1 months (7.5 months for endometroid ECs and 4.3 months for serous ECs) and an acceptable safety profile (49). PARPi maintenance therapy with Olaparib (UTOLA phase IIB trial with 53% of the patients included bearing the TP53 muta-tion) (50), Rucaparib versus Placebo estimated to finish this year (51), and Niraparib (for stage III/IV serous ECs)(52) after completion of chemotherapy are also being assessed in patients with advanced or metastatic ECs sensitive to platinum regimens. In the context of recent study results suggesting a potential combined benefit of chemotherapy and PARPi in p53abn cases, the transPORTEC RAINBO trial includes a red cohort of stage I-IV p53abn ECs randomized into two arms: one receiving combined chemoradiotherapy and one receiving combined chemoradiotherapy followed by Olaparib maintenance (8).…”