Molecular Profiling: Transforming the Diagnosis and Treatment of Endometrial Cancer - medicareist/sonali GitHub Wiki

Endometrial Cancer: Advancements in Detection, Treatment, and Personalized Approaches Endometrial cancer, a type of cancer that begins in the lining of the uterus (the endometrium), is increasingly becoming the most common gynecologic malignancy globally. Recent news highlights significant strides in understanding its molecular basis, improving diagnostic techniques, and tailoring treatment strategies for better patient outcomes.

Molecular Profiling Revolutionizing Endometrial Cancer Classification and Treatment: Researchers are increasingly recognizing the importance of molecular profiling in endometrial cancer. This involves analyzing the genetic makeup of tumors to identify specific subtypes with distinct behaviors and responses to therapy. Recent studies have categorized endometrial cancer into four main molecular subtypes: POLE-mutated (ultramutated), MSI-high (hypermutated), copy number low, and copy number high (often TP53-mutated). This classification is becoming crucial in guiding treatment decisions, particularly for advanced and recurrent disease.

Immunotherapy Shows Significant Promise in Advanced and Recurrent Endometrial Cancer: Immunotherapy, which harnesses the body's own immune system to fight cancer, is demonstrating remarkable success in treating advanced and recurrent endometrial cancer, especially in the MSI-high subtype. Recent clinical trials have shown durable responses and improved survival rates with immune checkpoint inhibitors in patients who have progressed on standard chemotherapy. This has led to the integration of immunotherapy into treatment guidelines for specific molecular subtypes.

Minimally Invasive Surgery Remains the Standard for Early-Stage Disease: For early-stage endometrial cancer, minimally invasive surgery, such as laparoscopic or robotic hysterectomy, continues to be the standard of care. These approaches offer benefits like smaller incisions, less pain, shorter hospital stays, and faster recovery compared to traditional open surgery. Ongoing research focuses on refining surgical techniques and identifying patients who may be candidates for less extensive surgery based on molecular risk factors.

Hormonal Therapy Effective for Low-Grade, Early-Stage, and Recurrent Endometrial Cancer: Hormonal therapy, particularly progestins, plays a significant role in treating certain types of endometrial cancer, especially low-grade endometrioid tumors that express hormone receptors. It can be used as primary treatment for early-stage disease in women who wish to preserve fertility or as a palliative treatment for recurrent disease. Research continues to explore the optimal use and duration of hormonal therapy, as well as the role of aromatase inhibitors in specific settings.

Radiation Therapy Adapted Based on Risk Factors and Tumor Characteristics: Radiation therapy, including external beam radiation and brachytherapy, remains an important adjuvant treatment for endometrial cancer, particularly for patients with higher-risk features. Advances in radiation planning and delivery techniques aim to maximize local control while minimizing side effects. The use of molecular profiling is also being investigated to tailor the use and intensity of radiation therapy.

Liquid Biopsies Emerging as a Potential Tool for Early Detection and Monitoring: Liquid biopsies, which analyze blood or other bodily fluids for cancer-related biomarkers like circulating tumor DNA (ctDNA), are showing promise in endometrial cancer. They have the potential for earlier detection, monitoring treatment response, and identifying recurrence. Research in this area is rapidly evolving, with the hope of integrating liquid biopsies into clinical practice in the future.

Addressing Racial and Ethnic Disparities in Endometrial Cancer Outcomes: Studies continue to highlight disparities in endometrial cancer incidence and outcomes among different racial and ethnic groups. Research efforts are focusing on understanding the underlying biological, social, and economic factors contributing to these disparities to develop targeted interventions and improve equity in care.