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Feasibility of TP53-Mutated ctDNA Monitoring in High-Grade Endometrial Cancer Using Routine NGS.

Regine Marlin1, Mehdi Jean-Laurent2, Clarisse Joachim3

  • 1Pôle de Biologie, Génétique des Cancers, CHU de Martinique, Fort-de-France, 97200 Martinique, France.

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|April 14, 2026
PubMed
Summary
This summary is machine-generated.

Monitoring circulating tumor DNA (ctDNA) by tracking TP53 mutations shows promise for high-grade endometrial cancer (EC). This method can detect minimal residual disease and guide personalized treatment strategies.

Keywords:
TP53 mutationctDNA monitoringhigh-grade endometrial cancerliquid biopsyminimal residual diseasenext-generation sequencingrecurrence detection

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Area of Science:

  • Oncology
  • Molecular Diagnostics
  • Genomics

Background:

  • High-grade endometrial cancer (EC) presents poor prognoses, necessitating improved biomarkers for risk stratification.
  • Current prognostic tools for EC require enhancement, especially for aggressive histological subtypes.

Purpose of the Study:

  • To assess the feasibility and clinical utility of monitoring circulating tumor DNA (ctDNA) in high-grade EC.
  • To evaluate TP53 mutation tracking via next-generation sequencing (NGS) as a biomarker for disease monitoring.

Main Methods:

  • Somatic TP53 mutations in ctDNA were tracked using a routine NGS assay in 21 patients with high-grade EC.
  • Feasibility and correlation of ctDNA detection with clinical parameters and patient outcomes were analyzed.

Main Results:

  • Over 75% of patients with TP53-mutated high-grade EC showed detectable ctDNA during follow-up.
  • Baseline ctDNA detection strongly correlated with advanced FIGO stage (FIGO > I) and poorer survival outcomes (2-year RFS 18%, OS 40%).
  • Longitudinal ctDNA monitoring revealed persistence or reappearance indicated disease progression, often preceding radiological relapse, while early clearance suggested favorable outcomes.

Conclusions:

  • TP53-based ctDNA tracking via standard NGS is a feasible, sensitive, and clinically relevant approach for high-grade EC.
  • ctDNA serves as a real-time molecular marker for minimal residual disease and tumor dynamics.
  • This approach can enhance prognostic stratification and personalize clinical management for high-risk EC patients.