A1 Vertaisarvioitu alkuperäisartikkeli tieteellisessä lehdessä
Molecular subtype stratified outcomes according to adjuvant therapy in endometrial cancer
Tekijät: Jamieson Amy, Huvila Jutta, Leung Samuel, Chiu Derek, Thompson Emily F, Lum Amy, Kinloch Mary, Helpman Limor, Salvador Shannon, Vicus Danielle, Kean Sarah, Samouelian Vanessa, Grondin Katherine, Irving Julie, Offman Saul, Parra-Herran Carlos, Lau Susie, Scott Stephanie, Plante Marie, McConechy Melissa K, Huntsman David G, Talhouk Aline, Kommoss Stefan, Gilks C Blake, McAlpine Jessica N
Kustantaja: Academic Press
Julkaisuvuosi: 2023
Journal: Gynecologic Oncology
Tietokannassa oleva lehden nimi: Gynecologic oncology
Lehden akronyymi: Gynecol Oncol
Vuosikerta: 170
Aloitussivu: 282
Lopetussivu: 289
ISSN: 0090-8258
eISSN: 1095-6859
DOI: https://doi.org/10.1016/j.ygyno.2023.01.025
Verkko-osoite: https://doi.org/10.1016/j.ygyno.2023.01.025
OBJECTIVES
Recent data support the predictive implications of molecular subtype assignment in endometrial cancer (EC). Our objective was to retrospectively assess clinical outcomes according to adjuvant treatment received within EC molecular subtypes.
METHODS
Clinical outcomes (disease-specific and progression-free survival DSS/PFS) of EC patients from a single institution and population-based cohorts that had undergone molecular classification were assessed with respect to adjuvant therapy received and 2016 ESMO risk group.
RESULTS
2472 ECs were assessed; 184 (7.4%) POLEmut, 638 (25.8%) MMRd, 1223 (49.5%) NSMP and 427 (17.3%) p53abn. N = 774 (34.6%) of the cohort were ESMO 2016 high risk and 109 (4.8%) were advanced or metastatic. In patients with MMRd EC, assessed across and within stage, there was no observed benefit in DSS or PFS with the addition of chemotherapy +/- radiation compared to radiation alone in ESMO high risk (p = 0.694) or ESMO high, advanced, metastatic risk groups combined (p = 0.852). In patients with p53abn EC, adjuvant chemotherapy given with radiation was associated with significantly longer DSS compared to radiation alone in ESMO high risk (p = 0.007) and ESMO high, advanced and metastatic risk groups combined (p = 0.015), even when restricted to stage I disease (p < 0.001) and when compared in serous vs. non-serous histotypes (p = 0.009).
CONCLUSIONS
Adjuvant chemotherapy is associated with more favorable outcomes for patients with p53abn EC, including stage I disease and non-serous histotypes, but does not appear to add benefit within MMRd ECs for any stage of disease, consistent with PORTEC-3 molecular subanalysis. Prospective trials, assessing treatment efficacy within molecular subtype are needed, however these 'real-world' data should be considered when discussing adjuvant treatment with patients.
