Molecular Classification to Prognosticate Response in Medically Managed Endometrial Cancers and Endometrial Intraepithelial Neoplasia

Cancers - Tập 13 Số 11 - Trang 2847
Allison Puechl1, Daniel Spinosa2, Andrew Berchuck3, Angeles Alvarez Secord3, Kerry E. Drury2, Gloria Broadwater4, Janice Wong2, Regina Whitaker3, Nicolas Devos5, David L. Corcoran6, Kyle C. Strickland7, Rebecca A. Previs3
1Atrium Health, Division of Gynecologic Oncology, Levine Cancer Institute, Charlotte, NC 29204, USA
2Department of Obstetrics & Gynecology, Duke University Medical Center, Durham, NC 27710, USA;
3Duke Cancer Institute, Duke University Medical Center, Durham, NC 27710, USA;
4Duke Cancer Institute Biostatistics, Durham, NC 27710, USA;
5GCB, Department of Biostatistics & Bioinformatics, Duke University, Durham, NC 27710, USA;
6Duke Center for Genomics and Computational Biology, Durham, NC 27710, USA;
7DEPARTMENT OF PATHOLOGY, DUKE UNIVERSITY MEDICAL CENTER, DURHAM, NC 27710 USA

Tóm tắt

Background: The aim of this study was to evaluate whether molecular classification prognosticates treatment response in women with endometrial cancers and endometrial intraepithelial neoplasia (EIN) treated with levonorgestrel intrauterine system (LNG-IUS). Methods: Patients treated with LNG-IUS for endometrial cancer or EIN from 2013 to 2018 were evaluated. Using immunohistochemistry and single gene sequencing of POLE, patients were classified into four groups as per the Proactive Molecular Risk Classifier for Endometrial cancer (ProMisE): POLE-mutated, mismatch repair-deficient (MMRd), p53 wild type (p53wt), and p53-abnormal (p53abn). Groups were assessed relative to the primary outcome of progression or receipt of definitive treatment. Results: Fifty-eight subjects with endometrioid endometrial cancer or EIN treated with LNG-IUS were included. Of these, 22 subjects (37.9%) had endometrial cancer and 36 subjects (62.1%) had EIN. Per the ProMisE algorithm, 44 patients (75.9%) were classified as p53wt, 6 (10.3%) as MMRd, 4 (6.9%) as p53abn, and 4 (6.9%) as POLE-mutated. Of the 58 patients, 11 (19.0%) progressed or opted for definitive therapy. Median time to progression or definitive therapy was 7.5 months, with p53abn tumors having the shortest time to progression or definitive therapy. Conclusions: Molecular classification of endometrial cancer and EIN prior to management with LNG-IUS is feasible and may predict patients at risk of progression.

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Cancers

Tập 13 Số 11

2847

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