Related Experiment Video
Updated: May 12, 2025
Testing Targeted Therapies in Cancer using Structural DNA Alteration Analysis and Patient-Derived Xenografts
Published on: July 25, 2020
Genomic alterations, molecularly targeted therapy, and survival: a real-world Endometrial Cancer Molecularly Targeted
Angeles Alvarez Secord1, Victoria Bae-Jump2, Floor Backes3
1Duke School of Medicine, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Durham, NC, USA.
Objective:
Next-generation sequencing and tumor testing to direct therapy in advanced/recurrent endometrial cancer are frequently used, but the impact of this approach is unclear. We sought to confirm the proportion of patients with at least 1 actionable alteration and whether the use of molecularly targeted therapy was associated with improved survival in metastatic endometrial cancer.
Methods:
A multidisciplinary consortium was formed to study tumor testing and treatment with targeted therapies in advanced/recurrent endometrial cancer. Tumor testing and therapeutic decisions were physician's recommendations. The abstracted data included age, stage, grade, histology, race, ethnicity, treatment, genomic alterations, protein expression for Her2, p53, mismatch repair, estrogen and progesterone receptors, and survival. Statistical analyses were performed using SAS v9.4.
Results:
A total of 967 patients from 12 centers were included. The median age was 64 years (range; 22-93 years). Of the participants, 68.5% were White, 24.0% were Black, 2.0% were Asian, and 92.7% were non-Hispanic. A total of 656 (67.8%) patients had recurrent/persistent disease and received a median of two (range; 0-9) therapies. 902 (93.3%) underwent tumor testing. Overall, 576 (94.0%) patients with next-generation sequencing testing had at least 1 genomic alteration in 11 pre-specified genes. The most frequent alterations were PI3K (35.8%), TP53 (34.7%), and PTEN (26.5%) mutations, respectively. A subset of 233 patients received 292 matched biologic therapies, and the median follow-up was 29.7 months, while the median progression-free survival and overall survival were 6.9 and 20.5 months, respectively.
Conclusions:
The consortium facilitated the development of real-world data on the patterns of genomic testing and molecularly targeted therapy used in a racially and geographically diverse patient cohort with advanced/recurrent endometrial cancer. Survival improved for those receiving matched biologic therapies compared to chemotherapy.
Insights
Next-generation sequencing in advanced endometrial cancer frequently identifies actionable genomic alterations. Matched biologic therapies improved survival compared to chemotherapy in this patient cohort.
Area of Science:
- Oncology
- Genomics
- Precision Medicine
Background:
- Next-generation sequencing (NGS) and tumor testing are increasingly utilized for advanced/recurrent endometrial cancer.
- The clinical impact of these molecular profiling approaches remains under investigation.
Purpose of the Study:
- To determine the proportion of patients with actionable genomic alterations in advanced/recurrent endometrial cancer.
- To assess if molecularly targeted therapy improves survival in metastatic endometrial cancer.
Main Methods:
- A multidisciplinary consortium analyzed data from 967 patients across 12 centers.
- Tumor testing, including NGS, and treatment decisions were based on physician recommendations.
- Data included patient demographics, tumor characteristics, genomic alterations, protein expression, and survival outcomes.
Main Results:
- 93.3% of patients underwent tumor testing, with 94.0% of those receiving NGS identifying at least one genomic alteration.
- The most common alterations were PI3K (35.8%), TP53 (34.7%), and PTEN (26.5%) mutations.
- 233 patients received matched biologic therapies, showing improved progression-free and overall survival compared to chemotherapy.
Conclusions:
- Real-world data on genomic testing patterns and targeted therapy use were established for a diverse endometrial cancer cohort.
- Matched biologic therapies demonstrated a survival benefit in advanced/recurrent endometrial cancer patients.
More Related Videos
09:48An Orthotopic Endometrial Cancer Model with Retroperitoneal Lymphadenopathy Made From In Vivo Propagated and Cultured VX2 Cells
Published on: September 12, 2019
07:59Author Spotlight: Advancements in Molecular Biomarker Testing for Non-Squamous Non-Small Cell Lung Cancer
Published on: September 8, 2023
Related Concept Videos
02:57Targeted Cancer Therapies
There are several types of targeted therapies against...
01:21Cancer Survival Analysis