- Molecular classification has strong prognostic value in patients with high-risk endometrial carcinoma.
- Patients with the p53abn subtype had the worst survival in this trial but experienced a significant survival benefit with adjuvant chemoradiotherapy vs radiotherapy alone.
Why this matters
- Molecular profiling can help in treatment decision-making.
- Molecular analysis was performed on tissue from 423 patients with high-risk endometrial cancer enrolled in the PORTEC-3 trial.
- Funding: Dutch Cancer Society.
- Molecular analysis was successful in 97% of patients.
- 4 molecular cancer subtypes were identified:
- p53abn (22.7%).
- POLEmut (12.4%).
- MMRd (33.4%).
- NSMP (31.5%).
- Respective 5-year recurrence-free survival (RFS) and OS in patients with molecular subtype:
- p53abn: 48.0% and 54.0%.
- POLEmut: both 98.0%.
- MMRd: 71.7% and 81.3%.
- NSMP: 74.4% and 88.5%.
- Compared with the MMRd subtype, RFS (HR, 2.517; P<.001 and os were significantly worse with the p53abn subtypes p=".001).</li">
- No significant difference in clinical outcome among histologies in patients with the p53abn subtype.
- Patients with a p53abn molecular subtype experienced significant improvement with adjuvant chemoradiotherapy vs radiotherapy alone:
- RFS: HR, 0.52 (P=.021).
- OS: HR, 0.55 (P=.049).
- Patients with the POLEmut subtype had similar RFS and OS with adjuvant chemoradiotherapy vs radiotherapy (both P=.637).
- Limited power for analysis by molecular subgroup.