Abstract | OBJECTIVES: To assess whether comprehensive genomic profiling (CGP) in the setting of routine clinical care allows molecular classification of recurrent endometrial cancer (EC) into the four Cancer Genome Atlas (TCGA) categories: POLE ultramutated, microsatellite instable, copy-number low, and copy-number high and whether this approach can identify genomic alterations (GAs) which inform treatment decisions. METHODS: Archival tissues from 74 patients diagnosed with recurrent EC were prospectively analyzed using hybrid-capture-based genomic profiling. Tumor mutational burden and microsatellite instability were measured. Clinically relevant GAs (CRGAs) were defined as GAs associated with targeted therapies available on-label or in mechanism-driven clinical trials. RESULTS: Using POLE mutational analysis, mismatch repair status, and p53 mutational analysis as surrogate for 'copy-number' status CGP segregated all cases into four TCGA molecular subgroups. While recurrent serous ECs were predominantly copy-number high, we found no clear prevalence of a specific molecular subtype in endometrioid, clear cell or undifferentiated tumors. Every tumor sample had at least one GA and 91% (67/74) had at least one CRGA. In this series 32% (24/74) of patients received a matched therapy based on the results of CGP. Objective responses to the matched therapy were seen in 25% (6/24) of patients with an additional 37.5% (9/24) achieving stable disease leading to a clinical benefit rate of 62.5% with a median treatment duration of 14.6 months (range 4.3-69 months). CONCLUSIONS: CGP allows molecular classification of EC into four TCGA categories and allows identification of potential biomarkers for matched therapy in the setting of routine clinical care.
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Authors | Emily N Prendergast, Laura L Holman, Annie Y Liu, Tiffany S Lai, Maira P Campos, Jacquline N Fahey, Xiaoyan Wang, Nabilah Abdelaal, Jian Yu Rao, Julia A Elvin, Kathleen M Moore, Gottfried E Konecny, Joshua G Cohen |
Journal | Gynecologic oncology
(Gynecol Oncol)
Vol. 154
Issue 3
Pg. 461-466
(09 2019)
ISSN: 1095-6859 [Electronic] United States |
PMID | 31257009
(Publication Type: Journal Article)
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Copyright | Copyright © 2019 Elsevier Inc. All rights reserved. |
Topics |
- Adult
- Aged
- Aged, 80 and over
- DNA Mutational Analysis
- Endometrial Neoplasms
(drug therapy, genetics, pathology)
- Female
- High-Throughput Nucleotide Sequencing
- Humans
- Microsatellite Instability
- Middle Aged
- Neoplasm Recurrence, Local
(drug therapy, genetics, pathology)
- Neoplasm Staging
- Retrospective Studies
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