Precision in Endometrial Cancer: Personalized Treatment Strategies for pMMR and dMMR Endometrial Cancer-Charting the Course: Treatment Approaches for dMMR Endometrial Cancer

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Video Summary

This 2024 International Gynecologic Cancer Society symposium, moderated by Dr. Brian Slomovitz, focused on personalized management strategies for advanced or recurrent endometrial cancers, emphasizing proficient mismatch repair (PMMR) tumors and deficient mismatch repair (DMMR) subtypes. Key topics included molecular subclassifications, treatment sequencing, and targeted therapies in first-line metastatic settings. Case discussions highlighted complex treatment decisions for high-grade endometrial cancer with pelvic lymph node involvement, exploring options such as platinum-based chemotherapy combined with immunotherapy, PARP inhibitors, hormonal therapies, and antibody-drug conjugates (ADCs) like trastuzumab-deruxtecan. The panel emphasized that immunotherapy combined with chemotherapy has become a new standard, especially benefiting DMMR tumors, while PMMR tumors show more heterogeneous responses, necessitating better biomarkers for patient selection. PARP inhibitors hold promise, particularly in homologous recombination deficient subsets, but require further validation. Hormonal therapies remain a viable option for select patients with hormone receptor-positive tumors. Discussions also covered the challenges of toxicity management and trial design limitations, underscoring the need for prospective, biomarker-driven studies. Emerging therapies such as ADCs offer new hope, though regulatory approvals vary globally. Overall, the symposium underscored advancements in personalized, biomarker-driven approaches to improve outcomes for endometrial cancer patients.

Keywords

International Gynecologic Cancer Society

endometrial cancer

personalized management

mismatch repair

immunotherapy

PARP inhibitors

antibody-drug conjugates