Molecular characterization as new driver in prognostic signatures and therapeutic strategies for endometrial cancer

Cancer Treat Rev. 2024 May:126:102723. doi: 10.1016/j.ctrv.2024.102723. Epub 2024 Mar 27.

Abstract

Endometrial cancer (EC) incidence and mortality rates have been increasing, particularly among young females. Although more than 90% of ECs are sporadic, 5-10% are hereditary, a majority of which occurs within Hereditary Non-Polyposis Colorectal Cancer syndrome (HNPCC) or Lynch syndrome. The traditional histopathological classification differentiates EC between two main groups: type I (or endometrioid) and type II (including all other histopathological subtypes). However, this classification lacks reproducibility and does not account for the emerging molecular heterogeneity. In 2013, The Cancer Genome Atlas (TCGA) project proposed EC molecular classification defining four groups with different prognostic and predictive values and the current international guidelines are progressively establishing EC risk stratification and treatment based on both histopathological and molecular criteria. Our manuscript aims to summarize the current state of EC molecular characterizations, including germline alterations at the basis of hereditary EC predisposition, to discuss their clinical utility as prognostic and predictive markers.

Keywords: BRCA; Endometrial cancer; Mismatch repair; POLE; TP53.

Publication types

  • Review

MeSH terms

  • Biomarkers, Tumor / genetics
  • Colorectal Neoplasms, Hereditary Nonpolyposis / diagnosis
  • Colorectal Neoplasms, Hereditary Nonpolyposis / genetics
  • Colorectal Neoplasms, Hereditary Nonpolyposis / therapy
  • Endometrial Neoplasms* / genetics
  • Endometrial Neoplasms* / pathology
  • Endometrial Neoplasms* / therapy
  • Female
  • Humans
  • Prognosis

Substances

  • Biomarkers, Tumor