How would you approach a patient who previously had complete response to Carboplatin/Paclitaxel/Pembrolizumab and palliative pelvic RT for what was thought to be IVB endocervical adenocaricnoma who now has endometrial lesions demonstrating clear cell carcinoma that the pathologist believes reflects the same process as before, suggesting a misdiagnosed clear cell endometrial cancer?
At the time of her initial diagnosis, she had an endocervical and lower uterine segment tumor invading into the bilateral parametria and the bladder. She was on maintenance Pembro for 5 years and discontinued due to insurance coverage issues. Patient has a good performance status and PET shows no extrauterine evidence of disease.