VIDEO: Prognostic biomarkers of endometrial cancer

Editor’s note: This is an automatically generated transcript. Please notify iwaters@healio.com if there are concerns regarding accuracy of the transcription.

Historically, we used to think about endometrial cancer as having two types, the type that was more hormonally active and a type that was less hormonally active. And we described endometrial cancer according to how it looked under the microscope. But we know that these are really primitive or crude or old-fashioned ways to discriminate or differentiate endometrial cancers and what we now know is, by looking more specifically at the genome or the genomic profile of these cancers, that really, four separate groups have kind of emerged. And those four groups we have ways to test for. So, one of the groups is a group that has what we call POLE ultra-mutated state, that's a genomic profile that we can test for. Patients who have this state in their endometrial cancer actually have a very good prognosis even when they have relatively advanced or spread disease. And so those patients, we may be able to deescalate or give less therapies for those patients and we're exploring if that's truly safe in large worldwide studies right now. Another group of patients who are important biomarkers, if patients have what we call microsatellite unstable tumors or their tumors demonstrate mismatch repair gene deficiencies, and that results in tumors that may prognostically be a little worse behaving however, or also tend to be very responsive to immunotherapies. And so, we know in particular, immunotherapies can be effective treatments for those patients, potentially not only in advanced stages but also potentially in early stages. And so, there's some exciting work being developed around that. And then another important biomarker is hormonal status. So many endometrial cancers express estrogen and progesterone receptors. So, we have a lot of new drugs and old-fashioned drugs. So, drugs that have been on the market for a long time that specifically target hormone receptors. And so particularly useful for endometrial cancers. Another biomarker that can be helpful in some cancers is whether or not they express something called HER2 neu. This was an expression that we knew about for breast cancer. Not only is it a potentially a biomarker, but we actually have a directed or targeted therapy for tumors that express HER2 neu, so some endometrial cancers that express HER2 neu, we know that those patients, we have a drug called Herceptin or Trastuzumab, and Trastuzumab improves the remission rates for patients who express HER2 neu. So, we have a variety of novel biomarkers that we've found by looking and exploring at the genomes of these cancers rather than just simply looking at the cancers under the microscope. And we can tailor our therapies for patients according to that. And it gives us more options and options that are more likely to be effective for patients.