Personalized Management of Advanced or Recurrent Endometrial Cancers: Navigating pMMR, dMMR Subtypes, or Molecular Classifications-Therapeutic Strategies for dMMR/pMMR Endometrial Cancers: Insights from Case Based Analysis (2nd line metastatic)

Therapeutic Strategies for dMMR/pMMR Endometrial Cancers: Insights from Case Based Analysis (2nd line metastatic)

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Video Summary

Dr. Brian Slomovitz, Director of Gynecologic Oncology at Mount Sinai, Miami, moderated a symposium on managing advanced or recurrent endometrial cancers. The event, held at the International Gynecologic Cancer Society meeting in Dublin, Ireland, focused on molecular subclassifications, particularly proficient and deficient MMR subtypes, to improve patient treatment strategies. The symposium highlighted case-based analyses and treatment sequencing in second-line metastatic settings. Discussions emphasized the importance of molecular subgroups in treatment decisions, with Angelica Rodriguez presenting a case study of a 65-year-old doctor with endometrial cancer, exploring various treatment options, including lenvatinib and pembrolizumab. For mismatch repair-deficient patients, immune checkpoint inhibitors (IO) showed durable responses. In contrast, proficient patients benefited more from IO combined with lenvatinib, showing improved progression-free and overall survival. The conversation also touched on the potential of repeat IO therapies and the significance of biomarkers like HER2 and TROP-2. Aspects like biomarker testing and de-escalation of treatments were debated, with future strategies likely involving ADCs (antibody-drug conjugates) such as those in Merck's global clinical trials. The session underscored the need for personalized treatment approaches and ongoing research to refine molecular criteria in endometrial cancer management.

Keywords

endometrial cancer

molecular subclassifications

immune checkpoint inhibitors

lenvatinib

biomarkers

antibody-drug conjugates

personalized treatment