Back to the future: The impact of oestrogen receptor profile in the era of molecular endometrial cancer classification

Perrone, Emanuele; Capasso, Ilaria; Felice, Francesca De; Giannarelli, Diana; Dinoi, Giorgia; Petrecca, Alessandro; Palmieri, Luca; Foresta, Aniello; Nero, Camilla; Arciuolo, Damiano; Lorusso, Domenica; Zannoni, Gian Franco; Scambia, Giovanni; Fanfani, Francesco

doi:10.1016/j.ejca.2023.03.016

Cited by 5 publications

(1 citation statement)

References 39 publications

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“…21 Other factors that have been shown to have prognostic value include human epidermal growth factor receptor 2 (HER2), ER status and the presence of LVSI. [26][27][28] The International Federation of Gynecology (FIGO)Iee on Women's Cancer has recently updated the staging system to reflect new developments in our understanding of EC. 17 Based on advancements in molecular profiling, the FIGO Committee encourages complete molecular classification (e.g., dMMR, NSMP and p53abn status) for all patients.…”

Section: Improvements In Endometrial Cancer Classificationmentioning

confidence: 99%

Endometrial Cancer: Updates in Molecular Characterization and Treatment Opportunities

2024

healthbook TIMES Onco Hema

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Endometrial cancer (EC) is the most prevalent gynecological malignancy and the fifth most common type of female cancer in Switzerland. With an increasing incidence worldwide, EC represents a significant health and economic burden that will continue to grow. This review article aims to provide an overview of topics such as the epidemiology of EC, its risk determinants, advancements in tumor molecular subtyping, how molecular subtyping is changing risk ratification and disease staging, as well as updates to treatment recommendations on patient therapy from international guiding bodies. In particular, the stratification of patients by molecular subtype has led to advances in disease staging and has provided physicians with greater insight into selecting therapies individualized to the patient's tumor type. We will also review the various treatment modalities available for patients with EC and briefly cover ongoing clinical research in this field, including novel monotherapies and combination therapies in both newly diagnosed and recurrent disease.

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Section: Improvements In Endometrial Cancer Classificationmentioning

confidence: 99%

Endometrial Cancer: Updates in Molecular Characterization and Treatment Opportunities

2024

healthbook TIMES Onco Hema

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Analysis of the correlation between gut microbiome imbalance and the development of endometrial cancer based on metagenomics

Xing,

Yu,

Cui

et al. 2024

Medicine

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Endometrial cancer (EC) is the most prevalent gynecologic malignancy, with a higher risk in obese women, suggesting the potential involvement of gut microbiota in the progression of EC. However, there is no direct evidence of a connection between EC and the human gut microbiota. Using metagenomic sequencing, we investigated the relationship between gut microbiome imbalance and cancer development in patients with EC. In this prospective case–control study, we included 15 patients with EC based on endometrial biopsy in the case group and 15 women admitted to the hospital for female pelvic floor issues during the same time who did not have endometrial lesions from January 2023 to June 2023 in control group. The microbiota structure of EC cases and controls without benign or malignant endometrial lesions during the same time period was analyzed using metagenomic sequencing technology. We employed Alpha diversity analysis to reflect the richness and diversity of microbial communities. Statistical algorithm Bray-Curtis was utilized to calculate pairwise distances between samples, obtaining a beta diversity distance matrix. Subsequently, hierarchical clustering analysis was conducted based on the distance matrix. The results showed that the composition of bacterial colonies in both groups was dominated by Firmicutes, which had a higher proportion in the control group, followed by Bacteroidetes in the control group and Proteobacteria and Bacteroidetes in the case group. The abundance of Klebsiella (P = .02) was significantly higher, and the abundance of Alistipes (P = .04), Anearobutyricum (P = .01), and bacteria in Firmicutes such as Oscillospira and Catenibacterium was markedly lower in the case group than in the control group. These results demonstrated conclusively that a gut microbiome imbalance was associated with the development of EC.

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Molecular profile is a strong predictor of the pattern of recurrence in patients with endometrial cancer

Luzarraga Aznar,

Bebia,

López-Gil

et al. 2024

Int J Gynecol Cancer

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ObjectivesTo investigate the pattern of first recurrence of disease in patients with endometrial cancer according to molecular classification, and to assess the independent role of molecular profiling in each type of failure.MethodsRetrospective single-center study including patients diagnosed with endometrial cancer stage I–IVB (International Federation of Gynecology and Obstetrics 2009) between December 1994 and May 2022, who underwent primary surgical treatment and had a complete molecular profile. First recurrence was classified as isolated or multiple, and as vaginal, pelvic, peritoneal, nodal, and distant according to its location. The log-rank test and univariate and multivariate adjusted Cox regression models were used for comparison between groups.ResultsA total of 658 patients were included. Recurrence was observed in 122 patients (18.5%) with a recurrence rate of 12.4% among mismatch-repair deficient tumors, 14.5% among non-specific molecular profile, 2.1% among POLE-mutated, and 53.7% among p53-abnormal tumors. Recurrences were found to be isolated in 80 (65.6%) and multiple in 42 (34.4%) patients, with no differences in molecular subtype (p=0.92). Patients with p53-abnormal tumors had a recurrence mainly as distant (28.4%) and peritoneal (21.1%) disease, while patients with non-specific molecular profile tumors presented predominantly with distant failures (10.3%), and mismatch-repair deficient tumors with locoregional recurrences (9.4%).On multivariate analysis, p53-abnormal molecular profile was the only independent risk factor for peritoneal failure (OR=8.54, 95% CI 2.0 to 36.3). Vaginal recurrence was independently associated with p53-abnormal molecular profile (OR=6.51, 95% CI 1.1 to 37.4) and lymphovascular space invasion. p53-abnormal and non-specific molecular profiles were independent predictors for distant recurrence (OR=3.13, 95% CI 1.1 to 8.7 and OR=2.35, 95% CI 1.1 to 5.0, respectively), along with lymphovascular space invasion and high-grade tumors. Molecular profile was not independently associated with pelvic and nodal recurrences.ConclusionsEndometrial cancer featured different patterns of recurrence depending on the molecular profile. p53-abnormal molecular profiling was the only independent risk factor for peritoneal relapse, while non-specific molecular profile showed a strong association with distant failures.

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Back to the future: The impact of oestrogen receptor profile in the era of molecular endometrial cancer classification

Cited by 5 publications

References 39 publications

Endometrial Cancer: Updates in Molecular Characterization and Treatment Opportunities

Endometrial Cancer: Updates in Molecular Characterization and Treatment Opportunities

Analysis of the correlation between gut microbiome imbalance and the development of endometrial cancer based on metagenomics

Molecular profile is a strong predictor of the pattern of recurrence in patients with endometrial cancer

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