Clinical utility of comprehensive liquid molecular profiling in patients with advanced endometrial cancer

作者：Félix Blanc‐Durand, Géraldine M. Camilleri, Arnaud Bayle, Mihaela Aldea, Damien Vasseur, Kaïssa Ouali, Judith Michels, Patricia Pautier, Claudio Nicotra, Maud Ngo‐Camus, Ludovic Lacroix, Étienne Rouleau, Santiago Ponce‐Aix, Antoîne Italiano, Alexandra Léary · 发表于：Cancer · 年份：2024 · DOI：10.1002/cncr.35381 · 被引用次数：10 · 研究领域：Endometrial and Cervical Cancer Treatments、Cancer Genomics and Diagnostics、Genetic factors in colorectal cancer

BACKGROUND: Molecular characterization has significantly improved the management of advanced endometrial cancer (EC). It distinguishes four molecular subclasses associated with prognosis and personalized therapeutic strategies. This study assesses the clinical utility of cell-free DNA (cfDNA) profiling in EC to identify targetable alterations. METHODS: Women with metastatic or recurrent EC were prospectively recruited within the framework of the STING trial (NCT04932525), during which cfDNA was analyzed. Genomic alterations were identified with the FoundationOne CDx assay. Each molecular report underwent review by a molecular tumor board. Alterations were categorized via the European Society of Medical Oncology Scale for Clinical Actionability of Molecular Targets (ESCAT). RESULTS: A total of 61 patients were enrolled. The median age was 66.9 years, with 43% presenting frontline metastatic disease. All histologic subgroups were represented. Notably, 89% of patients yielded informative cfDNA analysis. Six tumors were classified with deficient mismatch repair/microsatellite instability (11%) and 37 as TP53 gene mutant (67%), and 12 had nonspecific molecular profiles (22%). Molecular classification based on liquid biopsy showed 87.5% accuracy in correlating with tissue results. Moreover, 65% of cases exhibited ≥1 actionable alteration, including 25% ESCAT I alterations and 13% ESCAT II alterations. Consequently, 16% of patients received a molecularly matched therapy, and present...