AI Article Synopsis

  • ctDNA (circulating tumor DNA) analysis shows promise in understanding endometrial cancer (EC), revealing significant genetic alterations in advanced/recurrent cases through a study of nearly 2000 patients.
  • The study identified that 91.6% of ctDNA samples had somatic mutations, with TP53 being the most frequently altered gene, linked to worse overall survival (OS) for patients.
  • Findings suggest that ctDNA testing is a feasible method and could serve as a potential biomarker for monitoring and improving outcomes in endometrial cancer patients.*

Article Abstract

Purpose: ctDNA is a novel technique extensively studied in solid tumors, although not currently well defined in endometrial cancer.

Experimental Design: A de-identified retrospective analysis of 1,988 patients with advanced/recurrent endometrial cancer was performed. In addition, an analysis of a real-world evidence cohort was completed (n = 1,266). Patients underwent ctDNA testing using Guardant360 during routine clinical care. The objective was to describe and assess molecular landscape using ctDNA.

Results: Among 1,988 ctDNA samples, at least one somatic alteration was detected in 91.6% (n = 1,821). Most frequently altered genes were TP53 (64%), PIK3CA (29%), PTEN (25%), ARID1A (20%), and KRAS (14%). Overall, 18.5% had amplifications, with the majority identified in CCNE1 (40.9%), PIK3CA (22%), and EGFR (19.3%). From the real-world evidence cohort, those with TP53 mutations had a worse overall survival (OS) versus those without TP53 mutations (P = 0.02) and those with TP53 comutations had an inferior OS in comparison with TP53-mutated only (P = 0.016). Amongst these, patients with a PIK3CA comutation (P = 0.012) and CCNE1 amplification (P = 0.01) had an inferior OS compared with those with only TP53 mutations. Fifty-seven patients with newly diagnosed endometrial cancer had at least two serial ctDNA samples showing evolution in detected variants compared with baseline samples, with TP53 being the most frequent change.

Conclusions: This study is one of the largest cohorts of ctDNA currently reported in endometrial cancer. The presence of TP53 mutation and other comutations detected by ctDNA have a negative effect on outcomes. This report suggests that ctDNA analysis is feasible and could become a useful biomarker for endometrial cancer.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11647206PMC
http://dx.doi.org/10.1158/1078-0432.CCR-24-2105DOI Listing

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