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High-intermediate risk endometrial cancer: moving toward a molecularly based risk assessment profile

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Abstract

In the USA, endometrial cancer (EMCA) incidence is increasing as the risk factors of obesity, diabetes, and hypertension become more prevalent. Although most EMCA is detected at an early stage and surgical intervention is curative, a subset of patients termed ‘high-intermediate risk’ (H-IR) experience an increased rate of recurrence. Unfortunately, adjuvant therapies in patients with H-IR EMCA have yet to increase overall survival. Historically, stratification of these patients from their low-risk counterparts incorporated clinical and pathologic findings. However, due to developments in molecular testing and genomic sequencing, tumor biomarkers are now being incorporated into the risk-assessment criteria in the hope of finding molecular profile(s) that could highlight treatment regimens that will increase patient survival. Since modern research aims to accurately identify patients with a higher risk of recurrence and develop effective interventions to improve patient survival, these molecular-based analyses could allow for an enhanced understanding of a patient’s true risk of recurrence to facilitate the rise of personalized medicine. This review summarizes key clinical trials and recent advances in molecular and genomic profiles that have influenced current treatment regimens for patients with H-IR EMCA and laid the foundation for subsequent research.

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Funding

Funding was provided by the Foundation for Women's Cancer (Wilma Williams Education, Clinical Research Award for Endometrial Cancer).

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Author notes

  1. Tavonna D. Kako and Maahum Z. Kamal: co-first authors.

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL, 35294, USA

    Tavonna D. Kako, Jhalak Dholakia, Carly B. Scalise & Rebecca C. Arend

  2. University of Alabama at Birmingham School of Medicine, Birmingham, AL, 35294, USA

    Maahum Z. Kamal

  3. O’Neal Comprehensive Cancer Center, University of Alabama at Birmingham, 1824 6th Avenue South, WTI 430 J, Birmingham, AL, 35233, USA

    Rebecca C. Arend

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  1. Tavonna D. Kako
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  2. Maahum Z. Kamal
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Correspondence to Rebecca C. Arend.

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Kako, T.D., Kamal, M.Z., Dholakia, J. et al. High-intermediate risk endometrial cancer: moving toward a molecularly based risk assessment profile. Int J Clin Oncol 27, 323–331 (2022). https://doi.org/10.1007/s10147-021-02089-2

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  • DOI: https://doi.org/10.1007/s10147-021-02089-2

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