Clinical Report: Molecular Subtyping and Immunotherapy in Endometrial Cancer

Overview

Endometrial cancer (EC) is increasingly prevalent, particularly among young women, necessitating fertility-sparing treatment (FST) options. Molecular subtyping reveals significant prognostic differences, with POLE mutations associated with better outcomes, while dMMR indicates poorer prognosis and higher recurrence rates.

Background

Endometrial cancer is one of the most common malignancies affecting women, with rising incidence rates linked to factors like obesity and delayed childbearing. Standard treatment typically involves hysterectomy, which eliminates fertility, prompting the need for fertility-sparing strategies. Recent advancements in molecular classification have provided insights into the varying prognoses associated with different subtypes of endometrial cancer.

Data Highlights

No numerical data available in the source material.

Key Findings

• Endometrial cancer incidence was approximately 417,000 new cases globally in 2020.
• POLE mutations are associated with a higher complete remission rate in fertility-sparing treatment.
• Patients with dMMR endometrial cancer have a higher recurrence rate post-complete remission.
• Traditional fertility-sparing regimens primarily utilize progestin therapy.

Clinical Implications

Clinicians should consider molecular subtyping when evaluating treatment options for young women with endometrial cancer seeking to preserve fertility.

Conclusion

Molecular classification plays a crucial role in guiding fertility-sparing treatment strategies for endometrial cancer.

Related Resources & Content

1. roswell park comprehensive cancer center, Physician Resources, 2023 -- Immunotherapies, Antibody Drug Conjugants Among Advances in Endometrial Cancer Treatment Options
2. Archives of Gynecology and Obstetrics, 2023 -- Subtype matters: ovarian endometriosis impairs ovarian reserve and embryo quality—should these patients consider fertility preservation?
3. Frontiers in Immunology, 2026 -- Immune heterogeneity and therapeutic resistance in gynecological malignancies
4. Policy Review, ESGO Guidelines, 2025 -- ESGO-ESTRO-ESP Guidelines for EC
5. Frontiers in Reproductive Health — Immunotherapy does not impair ovarian function in a mouse model of breast cancer
6. 2025 ESGO Guidelines for Endometrial Cancer
7. THE LANCET OncologySupplementary appendixThis appe
8. Pocket Guidelines Management of Patients with E
9. A practical guideline on the fertility‐sparing treatment of patients with endometrial carcinoma and atypical endometrial hyperplasia
10. Performance of molecular classification in predicting oncologic outcomes of fertility-sparing treatment for atypical endometrial hyperplasia and endometrial cancer - ScienceDirect
11. Molecular classification of patients undergoing fertility sparing management of endometrial cancer: a systematic review and meta-analysis - International Journal of Gynecological Cancer
12. Pembrolizumab plus Chemotherapy in Advanced Endometrial Cancer | New England Journal of Medicine
13. FDA approves pembrolizumab with chemotherapy for primary advanced or recurrent endometrial carcinoma | FDA
14. Dostarlimab for Primary Advanced or Recurrent Endometrial Cancer | New England Journal of Medicine
15. Significant overall survival benefit with dostarlimab plus chemotherapy in advanced endometrial cancer - Nierengarten - 2024 - Cancer - Wiley Online Library
16. FDA expands endometrial cancer indication for dostarlimab-gxly with chemotherapy | FDA
17. Lenvatinib plus pembrolizumab in previously treated advanced endometrial cancer: 5-year outcomes from the randomized, phase 3 Study 309/KEYNOTE-775 - PMC
18. NCCN Guidelines® Insights: Uterine Neoplasms, Version 3.2025 - PubMed