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Racial differences in endometrial cancer genomics and outcomes using UNCseqTM targeted DNA sequencing.

Meredith A Newton1, Jason D Merker2,3,4, Weida Gong2

  • 1University of North Carolina at Chapel Hill, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, United States.

Gynecologic Oncology Reports
|July 21, 2025
PubMed
Summary

Genomic differences in endometrial cancer (EC) between Black and White patients reveal disparities. Black patients had more aggressive tumor types and poorer survival outcomes, suggesting molecular drivers for racial disparities.

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Area of Science:

  • Oncology
  • Genomics
  • Cancer Research

Background:

  • Endometrial cancer (EC) exhibits significant racial disparities in incidence and outcomes.
  • Understanding the genomic underpinnings of these disparities is crucial for improving patient care.

Purpose of the Study:

  • To characterize genomic differences in endometrioid and serous endometrial cancers (ECs) between Black and White patients.
  • To investigate the impact of these genomic differences on clinical outcomes, including progression-free survival (PFS) and overall survival (OS).

Main Methods:

  • Targeted DNA sequencing using the UNCseq panel was performed on tumor tissues from 200 patients (31 Black, 169 White).
  • Clinicopathologic data were used to assess PFS and OS.
  • Tumors were subclassified based on modified TCGA criteria.

Main Results:

  • Black patients more frequently presented with serous histology and TP53 mutations compared to White patients.
  • Black patients experienced significantly shorter PFS and OS.
  • TP53 mutant tumors, regardless of race, showed the poorest PFS and OS.
  • Differences in somatic mutations, including ARID1A and PTEN, were observed between racial groups.

Conclusions:

  • Genomic analysis identified potential molecular drivers contributing to racial disparities in endometrial cancer.
  • Further research with larger, diverse populations is needed to validate these findings and explore therapeutic targets.