Dr Sinno on Molecular Characterization in Endometrial Cancer

Abdulrahman Sinno, MD, associate professor, Clinical Obstetrics Gynecology and Reproductive Sciences, director, Surgical Research and Education, Sylvester Comprehensive Cancer Center, discusses a pivotal shift in the understanding of endometrial cancer, highlighting the limitations of histology and the necessity of understanding the molecular characteristics of the disease to provide a comprehensive understanding of the disease.

Histological classification has traditionally been regarded as paramount for the prognosis of patients with endometrial cancer; however, emerging data regarding the molecular characteristics of the disease has made histology merely one aspect of the complex pathophysiology for this patient population, Sinno begins. The recognition that histology alone does not adequately reflect the biological behavior of the tumor has prompted a transition towards molecular profiling, he adds. This understanding aligns with previous observations in patients with endometrial cancer, where some patients with aggressive histology do not experience recurrence, and others with favorable histology may encounter early disease recurrence, Sinno continues.

Molecular characterization offers a more nuanced insight into the behavior of the cancer, facilitating improved prognostication and treatment stratification, he adds, noting that unlike histology, molecular profiling can more accurately predict a tumor's behavior and responsiveness to specific therapies.

Sinno emphasizes the need to revisit past therapeutic approaches in light of molecular sub-classifications. Many therapies previously deemed ineffective may yield different outcomes when tailored to patients with specific molecular profiles.

By stratifying patients based on molecular characteristics rather than lumping them together based solely on histology, clinicians can optimize treatment strategies and enhance therapeutic efficacy, he continues. The paradigm shift from histology-centered to a molecular-driven understanding of endometrial cancer offers a new perspective in personalized oncology, Sinno concludes.