Dr. Mutch on Biomarkers in Endometrial Cancer

David Mutch, MD, Ira C. and Judith Gall professor, vice chair of obstetrics and gynecology, chief, Division of Gynecologic Oncology, Washington University School of Medicine in St. Louis, Siteman Cancer Center, discusses molecular biomarkers in endometrial cancer.

There are currently no molecular markers for determining which treatment to give a patient with endometrial cancer, explains Mutch. The field has not had success in utilizing conventional marker such as lymphovascular space involvement, depth of invasion, grade of the tumor, or histologic type—whether it is papillary, serous, or clear cell.

However, there is molecular data from The Cancer Genome Atlas study showing that patients who have a POLE [polymerase epsilon] mutation—though they often have poorly differentiated tumors—almost never recur, says Mutch. If patients are routinely screened for POLE mutations, those patients do not need adjuvant therapy. By utilizing molecular characterizations, it is possible to eliminate many patients who might not need any additional therapy, Mutch explains.