Molecular classification of endometrial cancers translated into practice

2021 ◽  
Vol 86 (4) ◽  
pp. 258-262
Author(s):  
Jiří Presl ◽  
◽  
Tomáš Vaněček ◽  
Michael Michal ◽  
Jiří Bouda ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Current Knowledge ◽  
Molecular Genetic ◽  
Epidemiological Data ◽  
Molecular Classification ◽  
The Cancer Genome Atlas ◽  
Treatment Regimens ◽  
Molecular Features ◽  
Practice Methods

Summary: Objective: The main objective of the article is to clearly inform healthcare professionals about the newly implemented molecular classification of endometrial cancer into practice. Methods: Summary of current knowledge, recommendations and new procedures relating to molecular genetic examination of the tissues of patients with endometrial carcinoma. Results: Endometrial cancer is currently diagnosed on the base of histopathological morphology. According to the classical Bokhman division, we distinguish between two relatively wide groups of tumors which are different in pathogenesis: type I – estrogen-dependent tumors, clinically usually indolent, and type II – non-endometroid tumors, clinically aggressive, without dependence on estrogen stimulation. This classification fulfills a  didactic purpose and provides easy orientation for epidemiological data, but is not suitable for stratification due to the overlap of clinical, pathological and molecular features. The Cancer Genome Atlas project classifies endometrial tumors into 4  groups based on molecular genetic features. Conclusion: Integration of the histopathological findings along with molecular classification appears to be the best approach for evaluating each individual tumor. This will help to achieve the ideal stratifi cation of patients for treatment regimens.

scholarly journals Mismatch repair deficiency: a step forward personalized medicine in endometrial cancer?

2016 ◽  
Vol 4 (2) ◽  
pp. 34-41
Author(s):  
Chiara Della Pepa ◽  
Susana Banerjee ◽  
Angela George
Keyword(s):  
Endometrial Cancer ◽  
Copy Number ◽  
Current Knowledge ◽  
Prognostic Significance ◽  
Good Prognosis ◽  
The Cancer Genome Atlas ◽  
Therapeutic Implications ◽  
Repair Deficiency ◽  
Cancer Genome Atlas

Endometrial cancer (EC) is the most common female malignancy in the world, it has traditionally been classified into two subgroups based on histopathological features, however this dualistic classification does not take into consideration subtypes such as high-grade endometrioid EC. Recently, work performed as part of The Cancer Genome Atlas study has focused on molecular genomic classification of EC, with four distinct molecular subtypes described: 1. POLE ultramutated, associated with a good prognosis; 2. Microsatellite instability (MSI) hypermutated; 3. Copy number low and microsatellite stable; 4. Copy number high, serous like, associated with a poor prognosis. The subgroup of patients with MSI is of particular interest for a number of reasons, including the use of tumour screening to identify patients with Lynch syndrome, the prognostic significance of MSI, and the potential therapeutic implications. This review will focus on the current knowledge in these areas and potential future directions.

scholarly journals Molecular classification of the PORTEC-3 trial for high-risk endometrial cancer: Impact on adjuvant therapy

2019 ◽  
Vol 30 ◽  
pp. v899-v900 ◽  
Author(s):  
C.L. Creutzberg ◽  
A. Leon-Castillo ◽  
S.M. de Boer ◽  
M.E. Powell ◽  
L.R. Mileshkin ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
High Risk ◽  
Adjuvant Therapy ◽  
Molecular Classification

scholarly journals Interfocal heterogeneity challenges the clinical usefulness of molecular classification of primary prostate cancer

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Kristina Totland Carm ◽  
Andreas M. Hoff ◽  
Anne Cathrine Bakken ◽  
Ulrika Axcrona ◽  
Karol Axcrona ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Molecular Classification ◽  
Primary Diagnosis ◽  
The Cancer Genome Atlas ◽  
Clinical Usefulness ◽  
Whole Exome ◽  
Primary Prostate Cancer ◽  
Cancer Genome Atlas ◽  
Prostate Cancers

Abstract Prostate cancer is a highly heterogeneous disease and typically multiple distinct cancer foci are present at primary diagnosis. Molecular classification of prostate cancer can potentially aid the precision of diagnosis and treatment. A promising genomic classifier was published by The Cancer Genome Atlas (TCGA), successfully classifying 74% of primary prostate cancers into seven groups based on one cancer sample per patient. Here, we explore the clinical usefulness of this classification by testing the classifier’s performance in a multifocal context. We analyzed 106 cancer samples from 85 distinct cancer foci within 39 patients. By somatic mutation data from whole-exome sequencing and targeted qualitative and quantitative gene expression assays, 31% of the patients were uniquely classified into one of the seven TCGA classes. Further, different samples from the same focus had conflicting classification in 12% of the foci. In conclusion, the level of both intra- and interfocal heterogeneity is extensive and must be taken into consideration in the development of clinically useful molecular classification of primary prostate cancer.

scholarly journals Endometrial Cancer Patients: A Cohort Previous to Changes in Tumour Behaviour and Treatment Strategies

2011 ◽  
Vol 2011 ◽  
pp. 1-6
Author(s):  
F. K. L. Tournois ◽  
H. J. M. M. Mertens
Keyword(s):  
Endometrial Cancer ◽  
Cancer Treatment ◽  
Treatment Strategies ◽  
Patient Characteristics ◽  
National Guidelines ◽  
Treatment Regimens ◽  
Time Period ◽  
New Treatment ◽  
Figo Classification

Nowadays, the incidence of endometrial cancer is rising, especially of high-grade endometrial tumours. Recently, the FIGO classification of endometrial cancer has changed worldwide. Besides that, treatment strategies are changing. The purpose of this study was to analyse the adherence to the national guidelines of cancer treatment and to analyse patterns of disease relapse and survival. We focused on a group of patients () with endometrial cancer, in a time period in which new treatment strategies are not yet completely implemented. Because of multiple upcoming changes in patient characteristics, tumour classification, as well as treatment regimens, a more heterogeneous cohort of patients diagnosed with endometrial cancer will appear. From now on, all those changes will have their effects on the followup of conventional endometrial cancer treatment. In our opinion, it is, therefore, valuable to have the current, more homogenous, cohort clearly described.

scholarly journals The emerging role of molecular pathology in directing the systemic treatment of endometrial cancer

2021 ◽  
Vol 13 ◽  
pp. 175883592110359
Author(s):  
Amy Jamieson ◽  
Tjalling Bosse ◽  
Jessica N. McAlpine
Keyword(s):  
Endometrial Cancer ◽  
Molecular Subtypes ◽  
Treatment Decision ◽  
Molecular Classification ◽  
The Cancer Genome Atlas ◽  
Molecular Profile ◽  
Therapeutic Implications ◽  
Treatment Decision Making ◽  
Exciting Time ◽  
Classification Tool

Following the discovery of the four molecular subtypes of endometrial cancer (EC) by The Cancer Genome Atlas (TCGA) in 2013, subsequent studies used surrogate markers to develop and validate a clinically relevant EC classification tool to recapitulate TCGA subtypes. Molecular classification combines focused sequencing ( POLE) and immunohistochemistry (mismatch repair and p53 proteins) to assign patients with EC to one of four molecular subtypes: POLEmut, MMRd, p53abn and NSMP (no specific molecular profile). Unlike histopathological evaluation, the molecular subtyping of EC offers an objective and reproducible classification system that has been shown to have prognostic value and therapeutic implications. It is an exciting time in EC care where we have moved beyond treatment based on histomorphology alone, and molecular classification will now finally allow assessment of treatment efficacy within biologically similar tumours. It is now recommended that molecular classification should be considered for all ECs, and should be performed routinely in all high grade tumours. It is also recommended to incorporate molecular classification into standard pathology reporting and treatment decision-making algorithms. In this review, we will discuss how the molecular classification of EC can be used to guide both conventional and targeted therapy in this new molecular era.

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