Precision Medicine Applied to the Study of Endometrial Cancer: Application of NGS for Molecular Classification

NCT07006103 | Not Yet Recruiting DMC

• 1 other identifier: 6760
• Study Type: observational
• Target: 400
• Locations: 0 countries
• Sites: N/A

Brief Summary

In recent years, knowledge about cancer biology has expanded significantly. The study of gene expression profiles has revealed the heterogeneous nature and potential reclassification of the various tumor subtypes based on specific genetic alterations. This is of great importance since it allows a therapeutic approach more directed to the intrinsic characteristics of each tumor (precision medicine). Integrating clinicopathological information with molecular classification could provide new guidelines when approaching patients with EC, both in preoperative assessment and in adjuvant treatment and surveillance. The application of molecular classification in endometrial carcinomas shows a subgroup of patients with an excellent prognosis, corresponding to the POLEmut subgroup that could be reclassified with eventual therapeutic de-escalation. The clinical guidelines for the management of patients with endometrial cancer proposed by ESGO/ESTRO/ESP in 2020 recommend the use of this new classification, and warn that clinical management may be modified by the molecular classification in scenarios where adjuvant chemotherapy is considered (high-grade/high-risk disease).

Conditions

Endometrial Cancer, Endometrial Neoplasm

Keywords

endometrial cancer; molecular classification; POLEmut subgroup

Outcome Measures

Primary Outcomes (1)

• Distribution of Endometrial Cancer Molecular Subtypes Identified by Immunohistochemistry and POLE Sequencing

  Proportion of patients in each of the four molecular subtypes of endometrial cancer (POLE-ultramutated, microsatellite instability hypermutated, copy-number low, copy-number high) determined using immunohistochemistry for MMR proteins and TP53, and NGS-based sequencing of the POLE gene.

  At study inclusion (retrospective evaluation of cases from the last 5 years). Units: Percentage of patients per subtype

Secondary Outcomes (2)

• Association Between Molecular Subtypes and Histological Risk Categories.

  At study inclusion (retrospective evaluation of cases from the last 5 years).

• Time to Recurrence by Molecular Subtype

  At study inclusion (retrospective evaluation of cases from the last 5 years).

Eligibility Criteria

• Age: 18 Years+
• Gender Eligibility Details: The endometrium is a female organ
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Patients of Hospital Italiano de Buenos Aires. Section of Pathological Anatomy, Sequencing and Gynecological Oncology, and the "Norberto Quirno" Center for Medical Education and Clinical Research (CEMIC). Service of Pathological Anatomy, Molecular Pathology, Gynecology, Institute of Oncology, and Institute of Precision Medicine.

You may qualify if:

• Patients over 18 years of age with a diagnosis of EC diagnosed by histological biopsy and surgically treated sequentially in the participating centers in the last 5 years with clinical follow-up.
• Patients over 18 years of age, diagnosed with CE III-IV by histological biopsy, not susceptible to surgical treatment in each institution during the last 5 years in clinical follow-up. Cases with a diagnosis of carcinosarcoma (a rare subtype of endometrial carcinoma with sarcomatous transdifferentiation) are included.
• Material blocks fixed in formalin and embedded in paraffin with a tumor volume in the paraffin block of at least 1 cm3

You may not qualify if:

• The following uterine neoplasms will be excluded:
• Biphasic tumors (epithelial-mesenchymal) such as adenosarcoma.
• Mesenchymal neoplasms such as endometrial stromal sarcoma and leiomyosarcomas.
• Others: primary lymphoproliferative processes of the uterine body; neuroendocrine tumors; Gestational trophoblastic disease, secondary lesions either of the genital tract (example: cervical carcinomas with extension to the endometrium) or of distant sites (breast cancer metastasis).
• Patients with synchronous endometrial and ovarian carcinoma
• For technical reasons, they will be excluded
• tumors smaller than 0.2 cm in which sufficient material cannot be obtained for immunohistochemical and molecular biology determinations.
• Tumors with severe artifacts due to poor processing, such as autolysis.
• Samples with low-quality DNA
• Patients operated on outside participating centers.
• Patients under 18 years of age.
• Patients with primary non-surgical treatments (neoadjuvant chemotherapy).

Sponsors & Collaborators

• Hospital Italiano de Buenos Aires: lead
• CEMIC Buenos Aires: collaborator

Related Publications (9)

• Stelloo E, Nout RA, Osse EM, Jurgenliemk-Schulz IJ, Jobsen JJ, Lutgens LC, van der Steen-Banasik EM, Nijman HW, Putter H, Bosse T, Creutzberg CL, Smit VT. Improved Risk Assessment by Integrating Molecular and Clinicopathological Factors in Early-stage Endometrial Cancer-Combined Analysis of the PORTEC Cohorts. Clin Cancer Res. 2016 Aug 15;22(16):4215-24. doi: 10.1158/1078-0432.CCR-15-2878. Epub 2016 Mar 22.

  PMID: 27006490 BACKGROUND

• Talhouk A, McConechy MK, Leung S, Yang W, Lum A, Senz J, Boyd N, Pike J, Anglesio M, Kwon JS, Karnezis AN, Huntsman DG, Gilks CB, McAlpine JN. Confirmation of ProMisE: A simple, genomics-based clinical classifier for endometrial cancer. Cancer. 2017 Mar 1;123(5):802-813. doi: 10.1002/cncr.30496. Epub 2017 Jan 6.

  PMID: 28061006 BACKGROUND

• Hoang LN, Kinloch MA, Leo JM, Grondin K, Lee CH, Ewanowich C, Kobel M, Cheng A, Talhouk A, McConechy M, Huntsman DG, McAlpine JN, Soslow RA, Gilks CB. Interobserver Agreement in Endometrial Carcinoma Histotype Diagnosis Varies Depending on The Cancer Genome Atlas (TCGA)-based Molecular Subgroup. Am J Surg Pathol. 2017 Feb;41(2):245-252. doi: 10.1097/PAS.0000000000000764.

  PMID: 28079598 BACKGROUND

• Kobel M, Nelson GS. Letter in response to: McAlpine J, Leon-Castillo A, Bosse T. The rise of a novel classification system for endometrial carcinoma; integration of molecular subclasses. J Pathol 2018; 244: 538-549. J Pathol. 2018 Jun;245(2):249-250. doi: 10.1002/path.5068. Epub 2018 Apr 16. No abstract available.

  PMID: 29512840 BACKGROUND

• Cancer Genome Atlas Research Network; Kandoth C, Schultz N, Cherniack AD, Akbani R, Liu Y, Shen H, Robertson AG, Pashtan I, Shen R, Benz CC, Yau C, Laird PW, Ding L, Zhang W, Mills GB, Kucherlapati R, Mardis ER, Levine DA. Integrated genomic characterization of endometrial carcinoma. Nature. 2013 May 2;497(7447):67-73. doi: 10.1038/nature12113.

  PMID: 23636398 BACKGROUND

• Bendifallah S, Canlorbe G, Collinet P, Arsene E, Huguet F, Coutant C, Hudry D, Graesslin O, Raimond E, Touboul C, Darai E, Ballester M. Just how accurate are the major risk stratification systems for early-stage endometrial cancer? Br J Cancer. 2015 Mar 3;112(5):793-801. doi: 10.1038/bjc.2015.35. Epub 2015 Feb 12.

  PMID: 25675149 BACKGROUND

• Imai K, Kato H, Katayama K, Nakanishi K, Kawano A, Iura A, Konnai K, Onose R, Hirahara F, Miyagi E. A preoperative risk-scoring system to predict lymph node metastasis in endometrial cancer and stratify patients for lymphadenectomy. Gynecol Oncol. 2016 Aug;142(2):273-7. doi: 10.1016/j.ygyno.2016.06.004. Epub 2016 Jun 15.

  PMID: 27268220 BACKGROUND

• Bokhman JV. Two pathogenetic types of endometrial carcinoma. Gynecol Oncol. 1983 Feb;15(1):10-7. doi: 10.1016/0090-8258(83)90111-7.

  PMID: 6822361 BACKGROUND

• Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021 May;71(3):209-249. doi: 10.3322/caac.21660. Epub 2021 Feb 4.

  PMID: 33538338 BACKGROUND

Biospecimen

Retention: SAMPLES WITH DNA

tissue and DNA extract

MeSH Terms

Conditions

Endometrial Neoplasms

Condition Hierarchy (Ancestors)

Uterine Neoplasms; Genital Neoplasms, Female; Urogenital Neoplasms; Neoplasms by Site; Neoplasms; Uterine Diseases; Genital Diseases, Female; Female Urogenital Diseases; Female Urogenital Diseases and Pregnancy Complications; Urogenital Diseases; Genital Diseases

Central Study Contacts

Hernan García Rivello MD, PhD

CONTACT

+54 11 4959 0200; hernan.garciarivello@hospitalitaliano.org.ar

Romina Albite D Bsc, Phd

CONTACT

+54 11 4959 0200; romina.albite@hospitalitaliano.org.ar

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Head of Clinical Pathology Department

Study Record Dates

• First Submitted: May 16, 2025
• First Posted: June 5, 2025
• Study Start: June 1, 2025
• Primary Completion: July 1, 2025
• Study Completion (Estimated): December 1, 2026
• Last Updated: June 8, 2025

Record last verified: 2025-06